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Dilaudid (Hydromorphone Hydrochloride): Health Sqaure: "Dilaudid a narcotic analgesic, is prescribed for the relief of moderate to severe pain such as due to . Biliary colic (pain caused by an obstruction in the gallbladder or bile duct), Burns, Cancer, Heart attack, Injury (soft tissue and bone), Renal colic (sharp lower back and groin pain usually caused by the passage of a stone through the ureter), Surgery.”
http://www.healthsquare.com/newrx/DIL1137.HTM

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The action of Dilaudid (Hydromorphone Hydrochloride): intelihealth.com: "Opioids such as hydromorphone relieve pain by acting on specific areas of the spinal cord and brain that process pain signals from nerves throughout the body. Therapy with hydromorphone varies, depending on the cause of your pain. Some patients require long-term narcotic therapy. Side effects may be more likely with prolonged use. This medication may be habit-forming. Do not exceed recommended doses or increase the dose on your own. This drug is more effective if taken before pain becomes too severe."
http://www.safemedication.com/displaydrug.cfm?id=601148

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Dilaudid (Hydromorphone Hydrochloride): globalrph.com: "Dosage conversion chart" (including pediatrics) and links to the following: Principles of pain management, Adult pain management (U of M), Narcotic/opioid analgesic comparison, Dosing table for opioid analgesics, and Pediatric pain management (U of M).
http://www.globalrph.com/narcoticonv.htm

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Nursing considerations when giving Dilaudid (Hydromorphone Hydrochloride): pedspain.com: "oral bioavailablitliy is 62% of the intravenous dose. The majority of the metabolites are unchanged and excreted in the urine. Crosses the placenta and is excrete in breast milk. Metabolized in the liver and is excreted by the kidneys. Crosses the placenta and if taken regularly throughout pregnancy, babies may be born physically dependent and exhibit withdrawal signs. This should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Use shortly prior to delivery may cause respiratory depression in the newborn. May be excreted in breast milk and not recommended for use in breastfeeding mothers. ”
http://pedspain.nursing.uiowa.edu/Opioids/Dilaudit.htm

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Studies and comprehensive information concerning Dilaudid (Hydromorphone HCL): HeadachePainfree.Com: "Analgesic effects of single doses of hydromorphone HCL oral liquid administered to patients with post-surgical pain have been studied in double-blind controlled trials. Hydromorphone HCl is hydrogenated ketone of morphine which is a narcotic analgesic. High potency dilaudid is available in Amber ampules for subcutaneous (SC) or intramuscular (IM) administration. Each 1 ml of sterile solution contains 10 mg hydromorphone HCl with 0.2% sodium citrate, 0.2% citric acid solution."
http://www.headachepainfree.com/dilaudid.htm

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Dilaudid (hydromorphone) information and structure: opioids.com: "Hydromorphone (Dilaudid) can provide very potent and rapid analgesic effect through subcutaneous (s.c.) injection. Although hydromorphone is widely used in North America, no study has compared the analgesic efficacy, side effect profiles and patients' satisfaction with the method of injection of hydromorphone s.c. and meperidine i.m. for the immediate post-operative analgesia"
http://opioids.com/hydromorphone/structure.html

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Overdose with Dilaudid (hydromorphone): rxlist.com: “Dilaudid-HP (high potency) is a concentrated solution of Hydromorphone intended for use in narcotic-tolerant patients. Do not confuse Dilaudid-HP with standard parenteral formulations of Dilaudid or other narcotics. Serious overdosage with DILAUDID-HP is characterized by respiratory depression, somnolence progressing to stupor or coma, skeletal muscle flaccidity, cold and clammy skin, constricted pupils, and sometimes bradycardia and hypotension. In serious overdosage, particularly following intravenous injection, apnea, circulatory collapse, cardiac arrest and death may occur.”
http://www.rxlist.com/cgi/generic3/hydromorph.htm

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Comprehensive view of Dilaudid (hydromorphone) including clinical studies: The Cancer Network: "In open clinical trials in patients with terminal cancer, doses ranged from 1-14 mg SC or IM; 1 patient received 30 mg SC on 2 occasions. In these trials, both SC and IM injections were well tolerated, with minimal pain and/or burning at injection site. A gradual increase in dose may be needed if analgesia is inadequate, tolerance occurs, or if pain severity increases. Drug is indicated in narcotic-tolerant patients who require larger-than-usual doses of narcotics for adequate pain relief. Because a smaller injection volume can be used than with other parenteral narcotics, discomfort associated with IM or SC injection of an unusually large volume of solution can be avoided.”
http://www.cancernetwork.com/drugs/Dilaudid.htm

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Dilaudid (Hydromorphone); ‘Pain management and provider liability: no more excuses.’: Journal of Law, Medicine & Ethics: "pain(1) is undertreated in the American health-care system at all levels: physician offices, hospitals, long-term care facilities. (2) The result is needless suffering for patients, complications that cause further injury or death, and added costs in treatment overall. The health-care system's failure to respond to patient pain needs corrective action. Excuses for such shortcomings are simply not acceptable any longer…. The possible reasons for health-care providers' failures to properly manage pain are many.” http://www.findarticles.com/cf_0/m0DPE/1_29/75086657/p1/article.jhtml?term=+Narcotics++Therapeutic++use

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