# SINGLE DOSE TREATMENT

SINGLE DOSE TREATMENT

SINGLE DOSE TREATMENT

Injection Type Age Renally Less than 50kg DOSE

Impaired (110 lbs.)

IM < 65 NO NO 60 mg

IM > or = 65 YES YES 30 mg

IV < 65 NO NO 30 mg

IV > or = 65 YES YES 15 mg

MULTIPLE DOSE TREATMENT

Injection Type Age Renally Less than 50kg DOSE

Impaired (110 lbs.)

IM or IV < 65 NO NO 30 mg every 6

hours

IM or IV > or = 65 YES YES 15 mg every 6

hours

Maximum daily dose

should not exceed 120

mg

Maximum daily dose

should not exceed 60 mg

BREAKTHROUGH PAIN

Do not increase the dose or frequency of ketorolac. Consideration should be given to supplementing these regimens

with low doses of opioids as needed unless otherwise contraindicated.

CONVERSION CORNER

Bill Duffy, RN, BSN

G.C. is admitted for a Right Total Hip Replacement. Prior to admission she

was taking OxyContin® 640 mg po q 8 h. Postoperatively she is placed on

Patient Controlled Analgesia (PCA). Convert her OxyContin to morphine

and hydromorphone (Dilaudid®):

1. Calculate her 24 h. po OxyContin dose:

640 x 3 = 1920 mg/24 h

2. Convert 24 h. OxyContin to MS

Contin®:

OxyContin 10 mg =

MS Contin 15 mg.

10/1920 : 15/x

10 x = 28800

x =2880

MS Contin® = 2880/24 h.

3. Convert po MSO4 to IV.

15 mg po = 5 mg IV

Divide 2880/3 = 960 mg

4. To get hourly or basal rate

divide 960/24 = 40 mg/h.

If a Dilaudid® PCA is desired,

convert IV MSO4 to IV Dilaudid

1. 4 mg IV MSO4 = 1 mg IV

Dilaudid®. 40 mg/4 = 10 mg/h.

To calculate PCA bolus dose use 25%-

50% of hourly rate.