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💡
Non-Pharm for all: keep them cosy, warm and distracted
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Qld health paracetamol guideline
Nociceptive
- Mild: Paracetamol 1g QID + NSAID (Ibuprofen 200-400mg TDS)
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💡
Oldies get TDS paracetamol dosing
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- Moderate: mild + an IMMEDIATE RELEASE PO opioid
- Typical (μ receptors)
- Morphine: 7.5mg 4hrly. Use half dose if >75yo
- Oxycodone: 5mg 4hrly. on PBS Use half dose if >75yo max 30-60 24hrly
- Fentanyl
- Atypical (μ and other receptors)
- Tramadol: 50mg 4hrly on PBS
- Buprenorphine 200-400 (max 2400 per 24)
- Tapentadol: 50-100mg 4hrly max 500 per 24hrs
- codeine
- Severe: mild + double dose morphine or oxycodone IR
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💡 OPIOIDS: Watch resp rate and sedation score (SS>2 or RR<8 = reduce dose)
Not really a problem with tramadol, instead watch for serotonin syndrome
</aside>
Consider naloxone 400ug SC or IM