Analgesics

Section 8 - MEDICATION GUIDELINES

8.02 ANALGESICS

Morphine Sulfate / Analgesic

DESCRIPTION

• It is a potent analgesic that also causes some vasodilatation. It reduces myocardial oxygen demand.

INDICATIONS

• Chest pain unrelieved by Nitroglycerin, in Pulmonary Edema, sickle cell anemia crisis, and in treatment of pain for burns.

CONTRAINDICATIONS

• Significant hypotension, COPD, or hypersensitivity to the medication.

PRECAUTIONS

• It may cause respiratory depression. Naloxone should be readily available to counteract

the effects of Morphine Sulfate. DOSAGE

• Refer to appropriate PRACTICE PARAMETER for specific dosages.
• Pediatrics: 0.1 mg/kg, refer to Handtevy System for specific dosages

Nitrous Oxide (NITRONOX) / Analgesic

DESCRIPTION

• It is a relatively weak anesthetic agent with both sedative and analgesic properties.

INDICATIONS

• Pain control for angina, acute abdominal pain, cold injuries, extremity injuries, and burns.

CONTRAINDICATIONS

• Head injuries, chest injuries, COPD< pulmonary edema, pregnant patients under 20 weeks gestation, suspected bowel obstruction, decompression syndrome, and shock regardless of cause.
• May cause drowsiness, dizziness, respiratory depression, or arrest, nausea, vomiting, or euphoria. Pregnant EMS care providers, under 20 weeks gestation, should not be in the presence of NITROUS OXIDE due to the fact that it is an inert gas.

DOSAGE

• Self-administered 50% Oxygen and 50 % Nitrous mixture.

Fentanyl / Analgesic

DESCRIPTION

• Potent synthetic narcotic analgesic given for pain management in place of morphine and is also utilized with DAI (Drug Assisted Intubation).

INDICATIONS

• Chest pain unrelieved by Nitroglycerin, in Pulmonary Edema, and in treatment for non-cardiac related pain.

CONTRAINDICATIONS

• Hypersensitivity to the medication, Respiratory Depression, Acute/Severe Bronchial Asthma, Non-opiod-tolerant patients

PRECAUTIONS

• Acute Pancreatitis, Cardiac Arrhythmias, CNS Depression.

DOSAGE

• Pain Management; 1-2 mcg/kg IVP SLOW titrate to effect.
• DAI Assist; 3 mcg/kg up to 6 mcg/kg IVP SLOW Repeat if necessary
• DAI Assist in Pediatrics; 2 mcg/kg IVP SLOW