Common Pain Medications
EM Clerkship
Zack Olson, MD ; Mike Estephan, MD ; Maddie Watts, MD
4.9 • 816 Ratings
🗓️ 24 July 2016
⏱️ 10 minutes
🧾️ Download transcript
Summary
Acetaminophen. Ibuprofen. Hydrocodone. Ketorolac. Morphine. Hydromorphone.
Oral Acetaminophen (Tylenol)
* Give every 4-6 hours* Regular strength – 325mg* Extra strength – 500mg* Maximum Daily Dose – 3000mg
Oral Ibuprofen (Advil)
* NSAID* Give every 4-6 hours* Regular strength – 200mg* Therapeutic Ceiling – 400mg
Oral Hydrocodone-Acetaminophen (Vicodin, Norco)
* Give ever 4-6 hours* Common doses – 5-325mg, 7.5-325mg, and 10-325mg
IV/IM Ketorolac (Toradol)
* NSAID* Common dosing – 15-30mg* Therapeutic ceiling – 10mg
IV/IM morphine
* Classic dose (0.1mg/kg)* This would be 7-10mg in adults!* More COMMON dosing is 4mg* Repeat as needed
IV/IM Hydromorphone (Dilaudid)
* COMMON dosing – 0.5-1mg * This drug is notorious for bringing you to peer-review/MM conference* Be careful!
Contraindications to NSAIDS
* Pregnant patients* Elderly patients* Renal disease patients* Cardiac patients* GI/ulcer patients
Side Effects of Opiates
* Sedation* No driving* Do not mix with alcohol* Do not mix with other sedatives* Constipation* Opiate dependency/addiction
Additional Reading
* Pain Management In the Emergency Department: A Review (PubMed)* Myths in EM: The Anti-Inflammatory Properties of NSAIDS (ACEP Now)
Transcript
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| 0:00.0 | Hello, med students. This episode has been sponsored by Freed AI. Do you dread the thought of |
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| 0:45.2 | Hello, med students. Thank you for downloading this episode of the EM Clerkship Podcast. |
| 0:51.6 | My name is Zach Olson, and today we are covering another huge topic. How to Treat Pain. |
| 1:01.0 | In this episode, we are going to cover the six most important pain medicines to know for your |
| 1:07.6 | rotation, including doses. |
| 1:15.8 | Oral Tylenol, oral ibuprofen, |
| 1:22.9 | oral hydrocodone acetaminophen, such as Vicodin, and Norco. |
| 1:37.5 | IV Cotorilac, which is Toridol, IV morphine, and IV hydromorphone, which is dilaudid. |
| 1:48.7 | Those are the big six. All right? So starting with the basics, option one, oral acetaminophen, Tylenol, every four to six hours. |
| 1:55.4 | This is the world's single most amazing pain medicine. It is my favorite medicine. It's basically a super drug. It has been shown to be incredibly effective in numerous blinded studies, emphasis on blinded there, it's very, very |
| 2:04.0 | safe. The recommended maximum daily dose of Tylenol is 3 grams, 3,000 milligrams of Tylenol. |
| 2:15.0 | Regular strength Tylenol comes in these 325 milligram tablets. Extra strength |
| 2:21.1 | Tylenol typically comes in 500 milligram tablets. That means that the patient can be taking |
| 2:27.0 | at least six extra strength tablets of Tylenol per day. And this is still nowhere near the potentially toxic |
| 2:35.7 | dose, which is around 8 grams in adults. During a fast track shift yesterday, I gave an extra |
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