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J. Inhaled steroids k. Ipratropium bromide Atrovent ; l. Isoetharine Bronkosol ; m. Isoproterenol Isuprel ; n. Metaproterenol Alupent ; o. Mucomyst p. Nasalcort q. Racemic epinephrine r. Salbutamol Albuterol, Proventil, Ventolin ; s. Terbutaline sulfate Bricanyl ; 2. Familiar with effects of: a. Anectine b. Atropine c. Corticosteroids d. Digitalis e. Digoxin f. Dopamine g. Duramorph h. Heli ox therapy i. Ketamine j. Lidocaine k. Morphne sulfate l. Nipride m. Nitric oxide therapy n. Pavulon o. Pentamidine isethionate p. Propofol q. Theo-dur r. Valium s. Versed D. PHLEBOTOMY 1. Equipment & procedures a. Drawing blood from central line b. Drawing blood from peripheral line c. Drawing venous blood E. NEONATAL PEDIATRICS 1. Equipment & procedures a. Assist in high risk delivery b. Capillary blood gases c. ECMO d. O2 to tent e. Umbilical blood gases 2. Care of the infant or child with: a. Bronchopulmonary dysplasia BPD ; b. Croup.

May not be available in the National List, and in such instances it will be appropriate for the state health administration adopting the National List ; to include drugs as may be considered adequate to treat these diseases. 6. A committee of experts was constituted by the DGHS in February, 1996, to prepare the National Essential Drugs List. This committee selected a core group comprising of: Dr. P. Das Gupta Dr. S. D. Seth Dr. C. B. Sridhar Dr. M. R. Samuel Dr. J. N. Mohanty Dr. G. K. Biswas Dr. J. S. Bapna to prepare a preliminary list. The core group took note of the procurement of State Governments, different Central Government institutions e.g. CGHS, ESIC, GMSD, etc. ; and WHO Essential Drugs List. The tentative list was subjected to scrutiny for therapeutic efficacy, availability and cost-effectiveness by the core group in consultation with experts in different disciplines of medicine. The draft was finally adopted in the meeting of experts held on 4th April, 1996. 7. The list is intended to be a dynamic document, subject to change, with addition and or deletions, as medical knowledge advances and new drugs become available at remunerative pricing. The list uses generic names for scientific clarity. For convenience and ease of comparison, the same category numbers and headings have been used as in the WHO Model List 1995 ; . However, only the names of the active bases have been used, avoiding the mention of salts or esters, e.g. morphine instead of morphine sulphate. The quantity mentioned in the strength of the dosage forms refers to the base unless by established practice or by pharmacopoeial standard it refers to the salt or the ester. The quality control standards are as in Indian Pharmacopoeia unless the drug is not included in I.P. Drugs marked with an asterisk * ; are to be considered as complementary drugs, i.e. those that are used if the other drugs in the category are not available or they are required for specific patients, situations or locations for valid reasons. The names of drugs are followed by the following letters to indicate their need at various levels of medical care: P S T 11. Primary health care Secondary health care Tertiary health care Universal.
Zapidone 15 mg po lis prnsleep " morphine 11 ; 020 po q4h prnrib pain mg ~c ~ u'. Tient's perspective. J Rheumatol 20: 557-560, 1993 Bentley K, Head T: The additive analgesic efficacy of acetaminophen 1000mg, and codeine 60mg in dental pain. Clin Pharmacol Ther 42: 634640, 1987 Quiding H, Oikarinen V, Sane J, et al: Analgesic efficacy after single and repeated doses of codeine and acetaminophen. J Clin Pharmacol 24: 27-34, 1984 Schug S, Sidebotham D, McGuinnety M, et al: Acetaminophen as an adjunct to morphine by patient-controlled analgesia in the management of acute postoperative pain. Anesth Analg 87: 368-372, 1998 Cobby TG, Crighton IM, Kyriakides K, et al: Rectal paracetamol has a significant morphine.

1298. Kaymak C, Takmaz SA, Ozen M, et al. The Effects of Bispectral Index Monitoring on End-Tidal Desflurane Concentration. European Journal of Anaesthesiology 2004; 21 Suppl. 32 ; : A-158. Keidan I, Perel A, Shabtai EL, et al. Children Undergoing Repeated Exposures for Radiation Therapy Do Not Develop Tolerance to Propofol: Clinical and Bispectral Index Data. Anesthesiology 2004; 100 2 ; : 251-4. Kim HJ, Park EJ, Yum KW. Relationship between Bispectral Index, Sedation Score and Plasma Concentration of Midazolam for the Evaluation of Bispectral Index as a Monitoring Device in the Midazolam Intravenous Sedation Patients. Anesthesiology 2004; 101 3 ; : A-337. Kim KM, Shayani V, Loo J, et al. A Comparison of Recovery Characteristics after Sevoflurane Versus Desflurane Anesthesia in Morbidly Obese Patients Undergoing Laparoscopic Gastric Banding: A Prospective, Randomized Study. Anesthesiology 2004; 101 3 ; : A-125. Kin N, Konstadt SN, Sato K, et al. Reduction of Bispectral Index Value Associated with Clinically Significant Cerebral Air Embolism. Journal of Cardiothoracic and Vascular Anesthesia 2004; 18 1 ; : 82-4. Kitagawa N, Oda M, Kakiuchi T, et al. Neurological Evaluation by Intraoperative Wake-up during Carotid Endarterectomy under General Anesthesia. Journal of Neurosurgical Anesthesiology 2004; 16 3 ; : 240-3. Klockars JGM, Taivainen T, Hiller A, et al. Validation Study: Spectral EEG Entropy as a Marker of Hypnosis in Children. Anesthesiology 2004; 101 3 ; : A-330. Kobayashi S, Katoh T, Bito H, et al. Bispectral Index of Patients Under Xenon and Sevoflurane Combination Anesthesia. Anesthesiology 2004; 101 3 ; : A-341. Kodaka M, Okamoto Y, Handa F, et al. Relation between Fentanyl Dose and Predicted EC50 of Propofol for Laryngeal Mask Insertion. British Journal of Anaesthesia 2004; 92 2 ; : 238-241. Kodaka M, Okamoto Y, Koyama K, et al. Predicted Values of Propofol EC50 and Sevoflurane Concentration for Insertion of Laryngeal Mask ClassicTM and ProSealTM. British Journal of Anaesthesia 2004; 92 2 ; : 242-5. Koitabashi T. Integration of Suppression Ratio in the Bispectral Index. Journal of Anesthesia 2004; 18 2 ; : 141-3. Koitabashi T, Ouchi T, Innami Y, et al. The Integration of Suppression Ratio in BIS-XP Algorithm. Anesthesiology 2004; 101 3 ; : A-529. 1319. 1310. Koitabashi T, Ouchi T, Umemura N. [The Effect of Nitrous Oxide on the Central Nervous System Evaluated by the Bispectral Index under Various Levels of Propofol Anesthesia] Masui 2004; 53 6 ; : 650-3. Korhonen AM, Valanne JV, Jokela R, et al. A Comparison of Selective Spinal Anesthesia with Hyperbaric Bupivacaine and General Anesthesia with Desflurane for Outpatient Knee Arthroscopy. Anesthesia & Analgesia 2004; 99 6 ; : 1668-73. Kreuer S, Bruhn J, Kessler P, et al. Alaris AEP or BIS Monitoring during Desflurane-Remifentanil Anaesthesia A Comparison with a Standard Practice Group. European Journal of Anaesthesiology 2004; 21 Suppl. 32 ; : A-141. Kreuer S, Bruhn J, Larsen R, et al. Comparison of BIS and AAI as Measures of Anaesthetic Drug Effect during Desflurane-Remifentanil Anaesthesia. Acta Anaesthesiologica Scandinavica 2004; 48 9 ; : 1168-73. Kreuer S, Bruhn J, Larsen R, et al. Comparability of NarcotrendTM Index and Bispectral Index during Propofol Anaesthesia. British Journal of Anaesthesia 2004; 93 2 ; : 235-240. Kreuer S, Bruhn J, Larsen R, et al. Application of Bispectral IndexTM and Narcotrend IndexTM to the Measurement of the Electroencephalographic Effects of Isoflurane with and without Burst Suppression. Anesthesiology 2004; 101 4 ; : 847-54. Kreuer S, Wilhelm W, Grundmann U, et al. Narcotrend Index Versus Bispectral Index as Electroencephalogram Measures of Anesthetic Drug Effect during Propofol Anesthesia. Anesthesia & Analgesia 2004; 98 3 ; : 692-7. Kurasako T, Iwasaki E, Yaita Y, et al. Comparison of Bispectral Index Values and Hemodynamic Effects during Induction of Anesthesia with Propofol Infused Based on Lean Body Mass Versus Total Body Weight. Anesthesiology 2004; 101 3 ; : A-89. Lambert P, Junke E, Meistelman C, et al. Analysis of Bispectral Index, State and Response Entropy Values Upon Emergence from Anesthesia in Patients Anaesthetized with Propofol or Sevoflurane. European Journal of Anaesthesiology 2004; 21 Suppl. 32 ; : A-120. Lamont LA, Greene SA, Grimm KA, et al. Relationship of Bispectral Index to Minimum Alveolar Concentration Multiples of Sevoflurane in Cats. American Journal of Veterinary Research 2004; 65 1 ; : 93-8. Law-Koune JD, Liu N, Szekely B, et al. Using the Intubating Laryngeal Mask Airway for Ventilation and Endotracheal Intubation in Anesthetized and Unparalyzed Acromegalic Patients. Journal of Neurosurgical Anesthesiology 2004; 16 1 ; : 11-3.

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Figure 1 Cumulative morphine consumption mean, SD ; in the paracetamol ; , diclofenac I ; and combination L ; groups. For clarity error bars are omitted from the diclofenac group. At 6, 12, 18 and 24 h, the SD values of this group were 7.0, 9.0, 12.4 and 15.1 mg, respectively and naproxen. Fitzsimons MG, Gaudette RR, Hurford WE. Pharmacotherapy. 2004; 24 4 ; : 538-540. Introduction Topical anesthetic sprays, such as benzocaine, have been reported to cause methemoglobinemia. The common treatment for methemoglobinemia is intravenous Methylene Blue. This case report illustrates that initial doses of Methylene Blue may have the desired effects of decreasing the Methemoglobin MetHb ; levels. However, a rebound can occur with Methemoglobin levels reaching near fatal levels. Case Report A 37-year-old, 70 kg post-op male patient was scheduled for transesophageal echocardiogram. His oxygen saturation was 97% via pulse oximetry. He was given intravenous midazolam and fentanyl prior to the procedure. He received 4 sprays 120 mg ; of 20% benzocaine. The patient immediately developed respiratory distress with visible cyanosis. The pulse oximeter reading dropped to 89%. He was placed on 100% O2 and an ABG was drawn. The sample appeared brown in color. The ABG analysis showed: pH 7.41, PaCO2 49 mm Hg, PaO2 198 mm Hg. CO-Oximetry revealed a MetHb level of 55%. The patient was immediately treated with Methylene Blue 100 mg over the next 10 minutes. A repeated measurement of MetHb revealed a level of 25.2%. A second dose of Methylene Blue was given and subsequent sampling revealed a level of 22.7% MetHb. Sixty minutes later the next sample revealed an increased level of 59.9% MetHb. An 80 mg dose of Methylene Blue was given and the MetHb level decreased to 24.6%. Serial measurements of MetHb over the next 12 hours showed the levels returning to normal. See Table 1 ; Day 1 Time 4: 31 6: PaO2 mm Hg ; 198 228 214 --96 84 SpO2 % 88 94 90 MetHb % 55.0 25.2 22.7 mg Methylene Blue dose 100 mg 100 mg. Premedication in the dentistry of retarded, emotionally disturbed, or disabled children cerebral palsy ; presents special problems. There are several goals which are on a different level from those sought in normal children. Many times it is impossible to perform routine chores such as examination and cleaning in these patients. Premedication, as an adjunct in treatment, should, by sedating and tranquilizing the patient, induce co-operation and aid in obtunding him to pain. The usual pediatric dosage recommendations are totally unable to achieve these goals in these children. Promethazine * has been reported to be a useful sedative, preanesthetic medication by itself, " 2 to have a definite antiemetic effect, 3 and to be an effective supplement to anesthesia. It has been used in dentistry for control of postextraction edema, 5 pain and trismus, 6 and for pre-operative sedation. Steubner and Sadove8 established the sedative dose for children in preoperative use at 0.5 mg lb of body weight. Promethazine has been shown not to be depress respiration in therapeutic doses.9 Meperidine is a potent narcotic agent with sedative and depressant effects. Extensive studies have indicated its respiratory depressant effects to be as great as 10 mg. of morphine sulfate at a 75-mg. dosage.10 The concomitant use of promethazine meperidine has led to studies on the combination of these drugst which indicate that equivalent sedative activity can be achieved by replacing half the meperidine with promethazine.11 At the same time, the respiratory depression is not increased by promethazine, 12 so that the margin of safety is greatly increased. The combination has been used successfully in preoperative dentistry.13 and nasonex. Q: my husband is in morphine and vicodine. Dear To improve the services that we currently offer you, we are inviting you to attend for a medication review. This is to help you get the best from your medicine. During the review you will be able to and neurontin. He requested an increase in medication because he was seeing ghosts. 148. The following month, I.J. began to suffer severe psychiatric deterioration again. He. Pain 1998, 76 : 27-3 pubmed abstract publisher full text poulsen l, brosen k, arendt-nielsen l, gram lf, elbaek k, sindrup sh: codeine and morphine in extensive and poor metabolizers of sparteine: pharmacokinetics, analgesic effect and side effects and norvasc.

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Baclofen pump ing adderall for weightloss avix side effects reactions facts switzerland or zyprexa diabetes law suit and morphine & marijuana taken together. Intravenous administration may also be the best parenteral route in patients who, for other reasons, have an indwelling central or peripheral line 17 ; the relative potency ratio of oral to intravenous morphine is about 1: 3 18 ; the above guidelines produce effective control of chronic cancer pain in about 80% of patients and ortho. Release opioids at this time to treat unexpected exacerbations of pain or pain that occurs only with movement. These rescue doses 3, 46 ; of morphine, oxycodone, or hydromorphone start at 10% of the total daily opioid dose and are given every 1 to 2 hours as needed 13 ; . The dose of the oral transmucosal fentanyl lozenge must be individually determined 38 42 ; . Meperidine is not indicated for repeated dosing in patients with chronic severe pain 3, 8 ; . It has poor oral bioavailability and a short therapeutic half-life. Toxic levels of its metabolite, normeperidine, accumulate with repeated dosing or in patients with renal insufficiency and can cause dysphoria, myoclonic jerks, and seizures 50.

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By Julie Archer, julie wvcag If slow and steady wins the race, then some day soon candidates for the state legislature and governor will have the option of running for office free from direct dependence on private campaign contributions. The WV Clean Elections Act would establish an optional parallel track of public financing for candidates who agree to limit their spending and reject all private donations. This initiative has made tremendous progress since it was introduced during the 2002 legislative session. In 2003, this comprehensive approach to campaign finance reform had bipartisan sponsorship in both houses and an interim committee is currently studying the bill. At the August interims Subcommittee B of the Joint Judiciary Committee took up the WV Clean Elections Act and heard a presentation by Clean Elections "ambassador" Cecilia Martinez - who works for Senator John McCain as Executive Director of the Reform Institute for Campaign and Election Issues in Alexandria, VA. As Director of the Clean Elections Institute, Ms. Martinez advocated for implementation of Arizona's unique Clean Elections law, which serves as a model for WV's bill. Citizens for Clean Elections arranged Ms. Martinez's visit and hosted a reception in Charleston where Ms. Martinez presented a special video taped message to West Virginians from Senator McCain. Ms. Martinez was also the featured speaker at Citizens for Clean Elections' first "Democracy Rescue Forum" in Huntington. Citizens for Clean Elections plans more "Democracy Rescue Forums" in the months ahead and is working with Ms. Martinez to arrange a visit from Senator McCain. The coalition will also continue to closely monitor legislative action on the Clean Elections Act. Secretary of State Joe Manchin, a Clean Elections supporter, arranged for Maine's Secretary of State, Dan Gwadosky, to talk to the interim committee in October about the success of Clean Elections in his home state. 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Keep in mind that this information is not meant to be used without the expertise of your own doctor, who is familiar with your situation, medical history, and personal preferences. Participating in a clinical trial is an appropriate option for women at any stage of breast cancer. Taking part in the study does not prevent you from getting other medical care you may need.

Morphine patient-controlled analgesia PCA, bolus 1 mg, lockout 5 min ; was given for postoperative analgesia. Primary outcome measures were visual analog pain scores at rest and on moving sitting forward ; and PCA mogphine consumption. Mor0hine consumption was significantly larger in nimodipine patients at 12 h versus 29 15; P 0.04 ; , 24 h 62 versus 45 24; P 0.02 ; , and 48 h 88 versus 61 27; P 0.01 ; . There were no significant differences in pain scores at rest or moving or in time to first use of morphime analgesia. This study has demonstrated increased morphinee consumption after 12 h in postoperative patients receiving nimodipine, suggesting that, in patients undergoing knee replacement surgery, it has no adjunctive analgesic effect and may actually inhibit the analgesic effect of morphine. Anesth Analg 2006; 102: 504 and paxil. Medications used for physical medical conditions can also affect psychiatric medications. BlueReview 2006 is one more way that BlueCross BlueShield of Tennessee is working to keep you informed about the added benefits and services you receive from your health care plan. To learn more about your specific benefits and coverage, consult your contract or Evidence of Coverage. You can also visit bcbst. com anytime to find a physician, learn more about prescription drug benefits and access important health information to benefit you and your family. Questions? Just call the Member Service number listed on your BlueCross BlueShield of Tennessee ID card or visit bcbst and penicillin and morphine, for example, win32 morphine. Because of the differences in the sample groups. As life span increases and older people become healthier, they will have increasing expectations regarding their sexuality. Clinicians and professional helpers need to be aware of such problems, be ready to educate and advise older people on how best to adapt to physiologically altered responses and, in some cases, treat them by psychosexual counselling or chemotherapy as well as alleviate any physical problems. Most clinicians do not suggest alarm devices or medications until a child is at least seven years old and pepcid. This drug successfully treated the staph infection, however the side effects were horrifying.

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Epidural T8 level ; infusion of bupivacaine 0.05% with morphine 100 mg mL at 14 mL Metoclopramide, ranitidine. The above results further illustrate the differential effect of morphine and heroin in cns on the modulation of ltp. Table 4 camp levels in th + and cbp + mice pretreated with morphine and naloxone.

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This bill, having received the vote of a constitutional majority of the members elected, was declared passed, and all amendments not adopted were tabled pursuant to Senate Rule No. 5-4 a ; . Ordered that the Secretary inform the House of Representatives thereof and ask their concurrence in the Senate Amendment adopted thereto. On motion of Senator Sullivan, House Bill No. 1922, having been printed as received from the House of Representatives, together with all Senate Amendments adopted thereto, was taken up and read by title a third time. And the question being, "Shall this bill pass?" it was decided in the affirmative by the following vote: Yeas 58; Nays None. The following voted in the affirmative: Althoff Bomke Bond Brady Burzynski Clayborne Collins Cronin Crotty Cullerton Dahl DeLeo Forby Frerichs Garrett Haine Halvorson Harmon Hendon Holmes Hultgren Hunter Jacobs Jones, J. Lightford Link Luechtefeld Martinez Meeks Millner Munoz Murphy Noland Pankau Peterson Radogno Ronen Rutherford Sandoval Schoenberg Sieben Silverstein Sullivan Syverson Trotter Viverito Watson Wilhelmi.

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Twelve month periods thereafter even if they only have employment confirmed for the following six months, as is often the case for non-consultant hospital doctors who sign contracts every six months. The Irish Medical Organisation IMO ; is working with the Department of Justice, Equality and Law Reform, on the issue of visas for doctors and hopes to see substantial improvements in the system in the coming year. Please note that there are a number of states outside of the EU whose nationals do not require an entry visa for Ireland. You can access this information from the IMO website See Appendix II: A Useful Contact List ; . Any specific queries should be directed to the IMO Non-EU Graduates Committee. We recommend that you carry your hospital identification card ID ; with you at all times to avoid unnecessary confusion about your work status when dealing with authorities. Family members and Visas One of the problems doctors have had in the past is difficulty arranging entry visas for their spouse and dependent children. The government had stipulated a waiting period of 12 months before a doctor's family could apply for a visa. This situation clearly created significant stress for the families affected. Consequently, the IMO lobbied the Department of Justice, Equality and Law Reform on this issue and was successful in achieving a reduction in the waiting period to 3 months. Although not ideal, this effort demonstrates the impact an organisation like the IMO can have in effecting change. In view of the existing problems non-EU doctors can experience in terms of visas and registration, the Trainee Section recommends that all trainees in psychiatry should seriously consider joining the IMO. This organisation has formed a Non-EU Graduates Committee that has been very active in tackling some of the issues particular to doctors from outside the EU states. Racial Discrimination Unfortunately doctors are not immune from racial discrimination. In fact, in two surveys of trainees in psychiatry working in the eastern region of Ireland, 9% of trainees reported racial discrimination in both 1995 and 2000. These statistics demonstrate that 35% of non-EU doctors working in psychiatry experience racial discrimination. `Racial Discrimination' is defined in article 1 of the International Convention on the Elimination of All Forms of Racial Discrimination CERD ; as meaning: `Any distinction, exclusion, restriction or preference based on race, colour, descent, or national or ethnic origin which has the purpose or effect of nullifying or impairing the recognition, enjoyment or exercise, on an equal footing, of human rights and fundamental freedoms in the political, economic, social, cultural or any other field of public life'. It is important to note that Ireland ratified this convention CERD ; in December 2000 thus demonstrating the Government's ongoing commitment to resolutely ban racial discrimination in Ireland. For more information on this topic and in particular in relation to employment equality see the Department of Justice website justice.ie ; . The Trainee Section advises that you inform yourself about the legislation on this topic. Additionally, if you have concerns pertaining to discrimination you should discuss these with your Educational Supervisor or Tutor in the first instance.

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Reviewer No.1 check list for application for addition: Morphibe Modified Release MMR ; tablets 10mg, 30mg and 60mg. MILLHORN, D. E., F. L. ELDRIDGE, J. P. KILEY, AND T. G. WALDROP. Excitatory and inhibitory effects of morphine on the intercostal-to-phrenic respiratory reflex. Respir. Physiol. 62: 79-84.

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Oral administration is recommended, if contacts can be made with recipients at least every year; otherwise, injections should be given every two years. The range listed in each table entry expressed as mg iodine ; reflects currently available dose units, as follows: 1 capsule Lipiodol contains about 200 mg iodine, 1 ml Lipiodol contains about 480 mg iodine, 1 dose dispenser ; Oriodol contains about 300 mg iodine. Source: WHO UNICEF ICCIDD Consultation of IDD prevalence and program indicators and iodized oil. Geneva, November 3-5, 1992, for example, morphine picture. The study patients were a representative sample of patients who undergo CABG surgery in tertiary cardiac surgical centers. Patients were excluded only if they had conditions that would usuaiiy d i s them fiom being early extubation candidates, or if they had contraindications to the performance of spinal anesthesia. Therefore, there was no selection bias and the results of this study could be generalized to similar patient populations. One of the limitations of this study is the use of postoperative morphine requirements as a surrogate marker for the adequacy of pain control after surgery. However, this marker has been used in previous studies and has been correlated with postoperative pain scores 3 3-3 S, 37, 46 ; . Another Limitation of the current study is the lack of detailed assessment of postoperative pulmonary fnction tests. This rnight have helped cast Light on the pathophysiology of the changes in SpO, on discharge fiom KU.

David: i'm wondering if you know of any new antidepressant medications or depression treatments on the horizon that we should be looking for, that would help those with depression.

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Penlac nail lacquer is the only topical prescription drug for treating nail fungus infections. At a hearing on the defendants' motion in limine to exclude this evidence at trial, Dr. Robert Allen Kaiser, Nurse Grim's treating psychiatrist from March 1993 until 1997 when she completed her therapy, testified that, in his opinion, Nurse Grim did not abuse narcotics9 on or around July 28, 1994. Nurse Grim testified that she last used morphine in March 1993, and that she was not under its influence when she treated the appellant.10 The defendants also produced the results of thirty-eight drug tests conducted on Nurse Grim, all of which were negative for substance abuse. When changing routes of administration, an equianalgesic table is a useful guide for initial dose selection. Significant first-pass metabolism necessitates larger oral or rectal doses to produce analgesia equivalent to parenteral doses of the same opioid. Equivalent dosing recommendations represent consensus from limited available evidence, so they are guides only, and individual patients may require doses to be adjusted. An equianalgesic table such as this one adapted with permission from Levy ; can be used on the horizontal axis to switch routes of administration and on the vertical axis to switch between opioids. This and other analgesic tables are meant as appropriate guides, and treatment may vary between points. [We recommend the equianalgesic table on page 30; please note that neither table contains starting doses.] Two special circumstances deserve clarification: Equianalgesic Doses of Opioid Analgesics Oral Rectal Dose mg ; 100 15 4 Analgesic Parenteral Dose mg ; 60 0.1 1.5 M0rphine po ; For Methadone, equianalgesic ratio varies by morphine dose [These are not starting doses. We recommend the pocket guide included in this packet.] 100 mg 101 300 mg 301 600 mg 600 1000 mg Morphine po ; : Methadone po ; 3: 1 When converting to or from transdermal fentanyl patches, published data suggest that a 25-g patch is equivalent to 45 to 135 mg of oral morphine per 24 hours. However, clinical experience suggests that most patients will use the lower end of the range of morphine doses i.e., for most patients, 25 g is about equivalent to 45 to mg of oral morphine per 24 hours.

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References 1. Dutch Summary of Product Characteristics of Tramadol. : cbg-meb.nl IB-teksten 15509-15510-15511-1551215513 accessed 2 nd October 2002 ; . 2. The pharmacological basis of therapeutics. Ed. Hardman JG, Limbird LE. Tenth edition 2001, p 590. 3. Cherny N, Ripamonti C, Pereira J, Davis C, Fallon M, McQuay H et al. Strategies to manage the adverse effects of oral morphine: an evidence-based report. J Clin Oncol 2001; 19: 2542-54. de Larquier A, Vial T, Brjoux G, Descotes J. Syndrome srotoninergue lors de l'association tramadol et iproniazide. Thrapie 1999; 54: 767-70. Hiccup and apperent myoclonus after hydrocodone: review of the opiate-related hiccup and myoclonus literature. Clin Neuropharmacol 1999; 22: 87-92.