Medications

VAISNAVAS C.A.R.E. INC.

-C.A.R.E.

Counseling, Assistance, Resource, and Education
for the terminally-ill and their family

 

Common Medications Used in Hospice
Taken from
THE FINAL JOURNEY Complete Hospice Care For Departing Vaisnavas (Torchlight Publishing) (This list is not meant to be all inclusive)

 

--NON-OPIOIDS--

NSAIDs
Toradol
Trilisate
Indocin
Relafen

Aspirin

Acetaminophen
Tylenol

 

--Opioids--

Weak to Moderate
Darvocet
Darvon
Lortab
Percocet
Tylenol with Codeine
Tylox
Vicoden

Moderate to Strong
Oxycontin

OxyFast

Strong
Morphine
Roxanol
Morphine Sulfate Instant Release
Morphine Sulfate Elixir
Morphine suppositories
MS Contin

Strong Morphine Derivative
Dilaudid

Synthetic Opioid
Demerol

Non-Morphine Opioid
Fentanyl Transdermal System
(Duragesic patch)

--Co-Analgesics--

Nerve pain

Tricyclic  Antidepressants
Elavil
Norpramin
Pamelor
Sinequan
Tofranil

Anticonvulsants
Tegretol
Klonapin
Neurontin
Dilantin

Corticosteroids
Decadron
Prednisone

Bone Pain

Radiation Therapy
Indocin
Naprosyn
Trilisate
Motrin
Prednisone
Decadron

Gastric Distention Pain

Reglan
Gas-X
Mylanta
Phazyme

Rectal or Bladder Spasm Pain

B&O Suppository
Cystospaz

Muscle Spasm Pain

Valium
Flexeril

 

There are several resources available to learn more about the medications you or your patient are taking.

  • A  list of  medications commonly used in the hospice setting, along with benefits, side effects, and risk factors can be found in  THE FINAL JOURNEY- Complete Hospice Care For Departing Vaisnavas (Torchlight Publishing).
  • Click on a medication name on the left for a short explanation.
  • For medication information on the Web click on one of the links below:

**The next three links are outside links.  To get back to this page  hit your browser back button or save this page to your favorites before linking

msn. medication link This is a nice site with a search tool to look up drugs with either the brand or generic name.

Health Square link  This is a nice site also with a search tool to look up about 1,000 different  medications.

Rx List link  This is a great site with an easy to remember name and listing of over 4,000 medications.

 

**Please be advised, this list is not meant to be all inclusive, nor are all the side effects and considerations listed here. This listing does not take the place of Medical care and advice, but is offered as an informational tool only.

Toradol, Trilisate, Indocin, and Relafen:

  • Work on peripheral nervous system at the site of injury
  • For mild pain
  • Anti-inflammatory
  • Fever reducer

    Common Side Effects:
  • Dizziness
  • Headache
  • Gastrointestinal problems
  • Prolonged bleeding time
  • Itching and Rash

Considerations:

  • Always take with food
  • Do not exceed 1200 mg a day

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Aspirin

  • Mild pain
  • Anti-inflammatory
  • Fever reducer
  • Blood thinner

Common Side Effects:

  • Stomach irritation

Considerations:

  • Give with milk, food, or large glass of water
  • Never give to patient with impaired kidney or liver function, history of gastric ulcers, or other bleeding disorders

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Tylenol

  • Mild pain
  • Fever reducer

Common Side Effects:

  • Rash
  • Jaundice
  • Liver damage (from toxic doses)

Considerations:

  • Can give false positive glucose results
  • Do not exceed 2000 mg a day

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Darvocet, Darvon, Lortab, Percocet, Percodan, Roxicet, Tylenol with codeine, Tylox, Vicoden:

  • Work on Central Nervous System
  • For mild to moderate pain

Common Side Effects:

  • Dizziness
  • Sedation
  • Gastrointestinal problems
  • Itching and Rash
  • Headache
  • Dry mouth
  • Respiratory depression

Considerations:

  • Use with laxative/stool softener
  • Give an anti-emetic as needed for nausea

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Oxycotin

  • Works on the Central Nervous system
  • For moderate to severe pain

Common Side Effects:

  • Respiratory depression
  • Nausea, vomiting
  • Sedation
  • Itching
  • Headache
  • Dry mouth
  • Dizziness

Considerations:

  • Never break, crush, cut, or chew
  • Best if given "round-the-clock" (on a set schedule)

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OxyFast Concentrate Solution

  • Use for breakthrough pain between the every 12 hour Oxycotin doses

Common Side Effects:

  • Same as Oxycotin (See above)

Considerations:

  • This is a fast acting, highly concentrated solution

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Morphine

  • Soft tissue and visceral pain

  • Severe, chronic pain

  • Alters perception of and emotional response to pain

Common Side Effects

  • Sedation

  • Euphoria

  • Dizziness

  • Nightmares (with long acting oral forms)

  • Nausea, vomiting

  • Constipation

  • Rash and itching

  • Respiratory depression

Considerations:

  • Comes in oral, sublingual, suppository, and as a last resort in hospice IV, IM, or subcutaneous injections

  • Doses need to be titrat3ed

  • First 24-48 hours may cause sedation

Roxanol Concentrate

See Morphine

Considerations:

  • Bitter taste, may mix with 1-2 tbls. fruit juice

  • Place a few drops at a time under tongue or inside cheek

Morphine Sulfate Instant Release (MSIR)

See Morphine

Considerations:

  • Concentrated solution, capsules, or small tablets

  • May mix capsules in 1-2 tbsp applesauce or pudding

Morphine Sulfate Elixir

See Morphine

Considerations:

  • Not in concentrated form so larger amount of liquid must be given

Morphine suppositories

See Morphine

Considerations:

  • Use lubricant for comfort

MS Contin

See Morphine

Considerations:

  • Extended Release, long acting with duration of 12 hours

  • Can give orally or rectally

  • Best to use "round-the-clock" (on a schedule)

  • Never crush, break, or cut

  • Always awaken patient to give regularly scheduled dose

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Dilaudid

  • Moderate to severe pain

  • Alters perception of and emotional response to pain

Common Side Effects:

  • Sedation

  • Dizziness

  • Euphoria

  • Hypotension

  • Nausea, vomiting

  • Constipation

  • Respiratory depression

Considerations:

  • Comes in tablets, suppositories, syrup, IV, IM or SQ forms

  • Pain relief duration approximately four hours

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Demerol

  • Rapid onset and short acting

  • CNS stimulant

  • Used more for severe acute pain

Common Side Effects:

With toxicity:

  • Mild negative mood swings within 24 hours

  • Irritability

  • Tremors, twitches, seizures

Considerations:

  • Not drug of choice for terminally-ill patient

  • Not for chronic pain use

  • Acts like, but non-morphine

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Fentanyl Transdermal System (Duragesic patch)

  • Use for severe pain

  • For patient who cannot tolerate morphine

  • For patients who cannot tolerate anything by mouth

Common Side Effects:

  • Sedation

  • Dizziness

  • Euphoria

  • Hypotension

  • Bradycardia

  • Blurred vision

  • Nausea, vomiting

  • Constipation

Considerations:

  • Use with caution in patients with liver or kidney disease

  • Not for use when titration is required as it may take up to six days to reach equilibrium

  • Not good for fast relief of pain

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Elavil, Norpramin, Pamelor, Sinequan, Tofranil

  • Tricyclic Antidepressants

  • Given for nerve pain

Most Common Side Effects:

  • Dry mouth

  • Constipation

  • Sedation

Considerations:

  • Analgesic benefits may take several days to 1-2 weeks

  • May need to be given at bedtime to reduce daytime sedation effect

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Tegretol, Klonapin, Neurontin, Dilantin

  • Anticonvulsants

  • Given for nerve pain

Most Common Side Effects:

  • Dizziness

  • Drowsiness

  • Nausea

  • Headache

Considerations:

  • If increase in dosage is required, increase gradually

  • Pain relief is not immediate, may take several days to 1-2 weeks

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Decadron, Prednisone

  • Corticosteroids

  • Given for nerve pain

Most Common Side Effects:

  • Euphoria

  • Insomnia

  • Psychotic behavior

  • headache

  • Hypertension

  • Edema

  • GI irritation

  • Nausea, vomiting

Considerations:

  • Useful in nerve compression pain

  • Useful in a variety of other symptoms

  • Use cautiously in patients with: stomach or other GI ulcers, kidney or liver disease, high blood pressure, heart disease, seizure disorders, TB, or emotional instability

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Radiation Therapy

  • For bone pain

Most Common Side Effects:

  • Nausea, vomiting

  • Skin irritation (redness, soreness, burning)

Considerations:

  • Topical hydrocortisone cream may help with skin soreness

  • Avoid exposure to sunlight

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Indocin, Naprosyn, Trilisate, Motrin

  • NSAIDs

  • Given for bone pain

Most Common side Effects:

  • Dizziness

  • Headache

  • Confusion

  • Depression

  • Drowsiness

  • Hypertension

  • Blurred vision

  • Tinnitus

  • Hearing loss

  • Diarrhea

  • Stomach ulcers

Considerations:

  • Use with caution in patients with kidney or liver disease, heart disease, infection, and depression

  • Give oral dose with food, milk, or antacid to prevent GI problems

  • First drug of choice if Radiation therapy cannot be used

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Prednisone, Decadron

See Indocin...

Reglan

  • Anti-emetic

  • Used for nausea and vomiting

  • Used for gastric distention pain

Most Common Side Effects:

  • Restlessness

  • Fatigue

  • Drowsiness

  • Insomnia

  • Headache

  • Diarrhea

Considerations:

  • Use cautiously in patients with a history of depression or hypertension

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Gas-X, Mylanta, Phazyme, Mylicon

Simethicone

  • Anti-flatulent

  • Use with gastric distention pain

Most Common Side Effects:

  • None

Considerations:

  • Does not prevent formation of gas

  • Tablets should be chewed before swallowing

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B&O Suppository, Cystospaz

  • Given for rectal or bladder spasm pain

Most Common Side Effects:

  • Headache

  • Insomnia

  • Drowsiness

  • Weakness

  • Blurred vision

  • Dry mouth

  • Constipation

  • Urinary hesitancy

  • Fever

Considerations:

  • Use cautiously in patients with autonomic neuropathy, hyperthyroidism coronary artery disease, reflux, liver or kidney disease, and heart failure

  • Give 30 minutes to 1 hour before meals and at bedtime

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Valium

  • Given for muscle spasm pain

Most Common Side Effects:

  • Dizziness

  • Rapid heart rate

  • Fever

  • weakness

  • nausea, vomiting

  • insomnia

Considerations:

  • Use cautiously with patients with liver or kidney impairment, or depression

  • When using oral concentrate solution, dilute dose just before administering

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Flexeril

  • Given for muscle spasm pain

Most Common Side Effects:

  • Drowsiness

  • Headache

  • Dizziness

  • Dry mouth

  • Rapid hear rate

  • Constipation

Considerations:

  • Do not use in patients with hyperthyroidism, heart block, arrhythmias (unusual heart rhythms), or heart failure

  • Use cautiously in patients with a history of urine retention

  

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