Archive for the ‘Pain Prescription’ category

Dilaudid: Prescription Drug Abuse & Testing

August 18th, 2011
Tarun Gupta asked:




Dilaudid is the trade name of hydromorphone hydrochloride which is a hydrogenated ketone of morphine that is used as an opioid analgesic to treat moderate to severe pain. White coat clad chaps call it 4, 5?-epoxy-3-hydroxy-17 methylmorphinan-6-one hydrochloride in their language.

Some bacteria have been shown to be able to turn morphine into hydromorphone. As reported in the July 1993 issue of Applied Environmental Bacteriology, the bacterium Pseudomonas putida, serotype M10, a naturally occurring NADH-dependent morphinone reductase which lives in an aqueous solution containing morphine, forms a significant amount of hydromophone as an intermediary metabolite. Same way, codeine may also be turned into hydrocodone.

Dilaudid Prescription, Dosage & Administration:

Dilaudid, a narcotic analgesic, is prescribed drug for the relief of moderate to severe pain 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 etc.

Hydromorphone comes as a tablet and also in liquid form & thus can be taken orally. It also comes as a rectal suppository. Each 5 ml of Dilaudid oral liquid usually contains 5 mg of hydromorphone hydrochloride. In addition, other ingredients may include purified water, methylparaben, propylparaben, sucrose, and glycerin. Dilaudid oral liquid may contain traces of sodium metabisulfite. Although, dosage is adjusted by physician according to the severity of the pain and the response of the patient, however, frequently, oral forms are taken every 4-6 hours while the suppository is usually used every 6-8 hours.

Dilaudid Abuse:

Hydromorphone has been observed to be one of those habit-forming drugs. Hydromorphone is largely abused in US and is subject to criminal diversion. So, you should never take a larger dose than what is prescribed by your physician. Taking it more often or for a longer period than what your doctor tells you to is equally harmful and must be avoided at all costs.

Effects of Dilaudid Abuse:

Adverse effects of hydromorphone i.e. Dilaudid are similar to those of other opioid analgesics, and represent an extension of pharmacological effects of the opioid drug class. The major hazards of hydromorphone include respiratory and CNS depression. The most frequently observed adverse effects are sedation, nausea, vomiting, constipation, lightheadedness, dizziness and sweating.

Physical Dependence on Dilaudid:

Opioid analgesics such as Dilaudid may cause psychological and physical dependence. Physical dependence results in withdrawal symptoms in patients who abruptly discontinue the drug. Physical dependence usually does not occur to a clinically significant degree until after several weeks of continued opioid usage, but it may occur after as little as a week of opioid use. Physical dependence and tolerance are separate and distinct from abuse and addiction.

Miscellaneous:

If you are sensitive to or have ever had an allergic reaction to Dilaudid or narcotic painkillers, you should not take this medication.

To limit abuse of opioid drugs like Dilaudid it is necessary to properly assess the patient, employ proper prescription practices, periodically re-evaluate the opioid therapy, and properly dispense and store the drugs.

Demerol Testing:

As with other drugs, a diverse array of techniques is available to test for Dilaudid abuse. As anticipated, some amount of Dilaudid remains unchanged while rest of it forms different metabolites.

These unchanged Dilaudid or Dilaudid derivatives and their metabolized products can be detected using any of the following methods:

•Urine based Dilaudid/metabolite testing

•Hair follicle based Dilaudid/metabolite detection

•GC based Dilaudid/metabolite detection

•Mass spec based Dilaudid/metabolite testing

•Dilaudid/metabolite-specific antibody based diagnostic kits



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Urticaria Pigmentosa Treatment Tips

August 14th, 2011
Juliet Cohen asked:




Urticaria pigmentosa is the name given to a type of mastocytosis. Urticaria pigmentosa is a disease that produces skin lesions and deeply itching. It is caused by excessive numbers of inflammatory cells (mast cells) in the skin. Other forms include solitary mastocytoma (a single lesion) and systemic mastocytosis (involvement in organs other than the skin). Urticaria pigmentosa is the childhood form of mastocytosis. Mast cells are specialized cells of connective tissue that release substances such as histamine (a chemical important in the inflammatory process) and heparin (an anti-clotting agent) when the body’s alarm mechanism is set off. When mast cells cluster and multiply excessively (proliferate), histamine and heparin are released into the skin (mastocytosis).

The characteristic skin lesions of urticaria pigmentosa appear in these areas. Urticaria pigmentosa is an orphan disease, affecting fewer than 200000 people in the United States. Urticaria pigmentosa is most often seen in children, but it can occur in adults as well. Rubbing of a lesion produces a rapid wheal (a hive-like bump). Younger children may develop a fluid-filled blister over a lesion if it is scratched. A large histamine release from these extra mast cells may cause flushing, headache, diarrhea, a rapid heartbeat (tachycardia), and even fainting. Most common symptoms of urticaria pigmentosa is red or brown spots are often seen on the skin, typically around the chest and forehead. Symptoms can range from very mild (flushing, hives, no treatment needed) to life-threatening (vascular collapse).

Most treatments for mastocytosis can be used to treat urticaria pigmentosa. Corticosteroids can be used topically, inhaled, or systemically to reduce inflammation associated with mastocytosis. The use of antihistamines is the most common treatment. To keep the disease from spreading these will help fight off the itching and flushing. Albuterol and other beta-2 agonists open airways that can constrict in the presence of histamine. Patients with urticaria pigmentosa should avoid aspirin, codeine, opiates, procaine, alcohol. polymyxin B, hot baths, and vigorous rubbing after bathing and showering. Photochemotherapy form of ultraviolet radiation is the most effective treatment for adults with urticaria pigmentosa. Two or three treatments each week are required for several months.

Urticaria Pigmentosa Treatment and Prevention Tips

1. Antihistamines may relieve symptoms such as itching and flushing.

2. Disodium cromoglycate orally may be helpful in some cases.

3. Proton pump inhibitors help reduce production of gastric acid.

4. Corticosteroids can be used topically reduce inflammation associated with mastocytosis.

5. Avoid aspirin, codeine, opiates, procaine, alcohol. polymyxin B, hot baths.

6. Potent steroid creams applied for several months under occlusion can reduce itching and unsightliness.



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Pain Pill Addiction Withdrawal

July 15th, 2011
Dusty Lindemann asked:




When a person who has developed an addiction to pain medication decides to take charge of their lives and give up the pills, they often face a long road filled with the symptoms of withdrawal. The process of being taken off the pills differs from one person to another but there are common side-effects that almost everyone experiences. Understanding what they are before the process begins, can help anyone to deal with them better.

The most prevalent symptom of withdrawal from pain pill medication is an unrelenting sense of discomfort. The reason the individual took the pain pills to begin with was associated with pain. As the dependency grew, they likely had to consume more pills each day to dull the pain. Once the pills are taken away, that lingering pain is often still there, and can be more intense than ever. For this reason many physicians and therapists who are guiding someone through recovery will prescribe a non-narcotic pain reliever to help alleviate the pain. Although these less powerful medications often don’t provide adequate relief initially, eventually they are likely to help.

Another symptom of withdrawal is deep depression. This is very common among addicts of all kinds. When the individual realizes that they are giving up the medication crutch that they’ve been leaning on for months, or in many cases, years, they sink into depression. Therapy can be very helpful for this withdrawal symptom. Group therapy that involves the individual’s family can provide necessary and crucial support.

There are some pain medications that remain in the body for longer periods of time once the individual has stopped taking them. This naturally results in them facing a longer period where withdrawal symptoms may be present. In cases like this, doctors may prescribe medication that helps to lessen those symptoms. For an addict hesitant to take medication this can raise some questions. However, on the advice of a trusted physician, who is experienced in the detoxification process, the medication can make the process much easier.

Fighting against a pain pill addiction is a life-long struggle. One valid concern that many individuals who have beaten this type of addiction face is the fear that if they are ever facing surgery again or are severely injured that they will automatically become addicted to their pain relievers again. This is why it’s essential that if this does occur that they are honest with the attending medical personnel about their history with pain pill addiction. There are many non-narcotic prescription pain killers available that can provide relief without the risk of addiction occurring.

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