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Contraindications
Resp depression w/o resuscitative equipment, raised intracranial pressures, head injury, convulsive disorder, status asthmaticus, paralytic ileus, acute alcoholism. Comatose patients. Severe hepatic impairment (extended-release). Lactation. Concomitant or w/in 14 days of MAOIs use.
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Special Precautions
Patient w/ hypotension w/ hypovolaemia, CNS depression, toxic psychoses, delirium tremens, shock, hypothyroidism, prostatic hypertrophy and hyperplasia, severely impaired pulmonary function, adrenocortical insufficiency (e.g. Addison's Disease), kyphoscoliosis. Patient following GI surgery. Elderly. Moderate renal and hepatic impairment. Pregnancy (may cause neonatal withdrawal syndrome in prolonged use during pregnancy). Patient Counselling This drug may cause drowsiness and dizziness, if affected, do not drive or operate machinery. Monitoring Parameters Monitor relief of pain, resp and mental status, and BP. Monitor for signs of misuse, abuse, and addiction.
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Adverse Reactions
Apnoea, biliary spasm, bradycardia, confusion, constipation, dependence, difficulty w/ micturition, dizziness, drowsiness, dry mouth, dysphoria, euphoria, flushing, hallucinations, headache, hypotension, lightheadedness, miosis, mood changes, muscle rigidity, nausea, oedema, palpitation, postural hypotension, pruritus, rash, sedation, sexual dysfunction, shock, sleep disturbances, sweating, tachycardia, ureteric spasm, urinary retention, urticaria, vertigo, visual disturbances, vomiting.
Potentially Fatal: Resp depression, cardiac arrest, circulatory depression. |
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C
Prolonged use may cause neonatal opioid withdrawal syndrome.
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Drug Interactions
Additive depressant effects w/ sedative/hypnotics, general anaesth, antipsychotics (e.g. phenothiazines), tranquilizers, and neuromuscular blockers. Reduced analgesic effect and may precipitate withdrawal symptoms w/ mixed agonist/antagonist opioid analgesics (e.g. pentazocine, nalbuphine, butorphanol, buprenorphine).
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CIMS Class
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ATC Classification
N02AA03 - hydromorphone ; Belongs to the class of natural opium alkaloids. Used to relieve pain.
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