Dilaudid Hydromorphone 8mg


Active Ingredients:   8 mg Hydromorphone
Color:    White to Off-White
Shape: Rounded Triangle
Other:   Tablet
Manufacturer:  Mallinckrodt Pharmaceuticals

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What is Dilaudid Hydromorphone 8mg ?

Dilaudid Hydromorphone 8mg, also known as dihydromorphinone, and sold under the brand names Dilaudid among others, is a centrally acting pain medication of the opioid class. It is a derivative of morphine; to be specific, it is a hydrogenated ketone thereof. Comparatively, hydromorphone is to morphine as hydrocodone is to codeine—that is, a semi-synthetic drug. In medical terms, it is an opioid analgesic and, in legal terms, a narcotic. Hydromorphone is commonly used in the hospital setting, mostly intravenously (IV) because its bioavailability is very low orally, rectally, and intranasally. Sublingual administration (under the tongue) is usually superior to swallowing for bioavailability and effects; however, Dilaudid Hydromorphone 8mg is bitter and hydrophilic like most opiates, not lipophilic, so it is absorbed poorly and slowly through mouth membranes.[3]

Dilaudid Hydromorphone 8mg is much more soluble in water than morphine and, therefore, hydromorphone solutions can be produced to deliver the drug in a smaller volume of water. The hydrochloride salt is soluble in three parts of water, whereas a gram of morphine hydrochloride dissolves in 16 ml of water; for all common purposes, the pure powder for hospital use can be used to produce solutions of virtually arbitrary concentration. When the powder has appeared on the street, this very small volume of powder needed for a dose means that overdoses are likely for those who mistake it for heroin or other powdered narcotics, especially those that have been cut or ‘stepped on’ already.[4]

Very small quantities of hydromorphone are detected in assays of opium on rare occasions; it appears to be produced by the plant under circumstances and by processes which are not understood at this time and may include the action of bacteria. A similar process or other metabolic processes in the plant may very well be responsible for the very low quantities of hydrocodone also found on rare occasions in opium and alkaloid mixtures derived from opium. Dihydrocodeine, oxymorphol, oxycodone, oxymorphone, metopon, and possibly other derivatives of morphine and hydromorphone also are found in trace amounts in opium.

Side effects OF Dilaudid Hydromorphone 8mg

Adverse effects of Dilaudid Hydromorphone 8mg are similar to those of other potent opioid analgesics, such as morphine and heroin. The major hazards of hydromorphone include dose-related respiratory depression, urinary retention, bronchospasm and sometimes circulatory depression.[5] More common side effects include light-headedness, dizziness, sedation, itching, constipation, nausea, vomiting, headache, sweating, and hallucinations.[5] These symptoms are common in ambulatory patients and in those not experiencing severe pain.

Simultaneous use of Dilaudid Hydromorphone 8mg with other opioids, muscle relaxants, tranquilizers, sedatives, and general anesthetics can cause a significant increase in respiratory depression, progressing to coma or death. Taking benzodiazepines (such as diazepam) in conjunction with hydromorphone may increase side effects such as dizziness and difficulty concentrating.[6] If simultaneous use of these drugs is required, dose adjustment can be done.[7]

A particular problem that may occur with hydromorphone is accidental administration in place of morphine due to a mix-up between the similar names, either at the time the prescription is written or when the drug is dispensed. This has led to several deaths and calls for hydromorphone to be distributed in distinctly different packaging from morphine to avoid confusion.[8][9]

Massive overdoses are rarely observed in opioid-tolerant individuals, but when they occur, they may lead to circulatory system collapse. Symptoms of overdose include respiratory depression, drowsiness leading to coma and sometimes to death, drooping of skeletal muscles, low heart rate and decreasing blood pressure. In the case of an overdose, take the patient to the Emergency Department or call 911. At the hospital, individuals with hydromorphone overdose are provided supportive care such as assisted ventilation to provide oxygen, gut decontamination using activated charcoal through a nasogastric tube. Opioid antagonist such as naloxone can also be administered concurrent with oxygen supplementation. It works by reversing the effects of hydromorphone. It is only administered in the presence of significant respiratory depression and circulatory depression.[7]

The effects of overdose can be exaggerated by dose dumping if the medication is taken with alcohol.[10]

Sugar cravings associated with hydromorphone use are the result of a glucose crash after transient hyperglycemia following injection or a less profound lowering of blood sugar over a period of hours, in common with morphine, heroin, codeine, and other opiates.

As with other opioids, hydromorphone (particularly during heavy chronic use) often causes temporary hypogonadism or hormone imbalance.[11]

Neurotoxicity Dilaudid Hydromorphone 8mg

In the setting of prolonged use, high dosage, and/or kidney dysfunction, hydromorphone has been associated with neuroexcitatory symptoms such as tremor, myoclonus, agitation, and cognitive dysfunction.[12][13][14] This toxicity is less than that associated with other classes of opioids such as the pethidine class of synthetics in particular.

Withdrawal Dilaudid Hydromorphone 8mg

Users of hydromorphone can experience painful symptoms if the drug is suspended.[15] Some people can not tolerate the symptoms which result in continuous drug use[15]Symptoms of opioid withdrawal are not easy to decipher. There are differences between drug-seeking behaviors and true withdrawal effects.[16] Symptoms associated with hydromorphone withdrawal include:[15][16][17]

Abdominal pain
Unable to enjoy daily activities
Muscle and joint pain
Runny nose and excessive secretion of tears
Goose bump skin

In the clinical setting excessive secretion of tears, yawning and dilation of pupils are helpful presentations in diagnosing opioid withdrawal.[18] Hydromorphone is a rapid acting pain killer, however some formulations can last up to several hours, patients who stop taking this drug abruptly might experience withdrawal symptoms.[17][19] These can start within hours of taking the last dose of hydromorphone and can last up to several weeks.[15] Withdrawal symptoms in people who stopped taking the opioid can be managed by using opioids or non-opioid adjuncts.[20] Methadone is an opioid commonly used for this kind of therapy. However, the selection of therapy should be tailored to each specific person.[21] Methadone is also used for detoxification in people who have opioid addiction such as heroin or drugs similar to morphine.[21] It can be given orally or intramuscularly. There is controversy regarding the use of opioids for people experiencing withdrawal symptoms since these agents can themselves cause relapse on patients when they suspend therapy[15] Clonidine is a non-opioid adjunct that can be used in situations where opioid use is not desired such as in patients with high blood pressure.[22]



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