Sedation, analgesia and paralysis
Hydromorphone (Dilaudid) drip
Dilaudid
Dosing
| Start | 0.5–1 mg/h (PADIS range 0.5–3 mg/h) |
|---|---|
| Titrate | 0.25–0.5 mg/h, with boluses every 15–30 minutes |
| Maximum | No ceiling; most patients need under 3–4 mg/h |
| Common bags | 20 mg in 100 mL (200 mcg/mL); 50 mg in 50 mL (1 mg/mL) |
| Dose units | mg/h |
Line and administration
- Peripheral or central
Watch for
- About seven times as potent as morphine: check the concentration
- Respiratory depression
- Metabolite build-up in kidney failure (agitation, myoclonus)
Hydromorphone: full drug monographIndications, mechanism, pharmacokinetics, cautions and every dose the app lists.
In the one-pagers
- Sedation, Pain and Delirium ScalesPharmacology and ICU pitfalls: Hydromorphone: 0.5–3 mg/h: Potency errors; metabolite myoclonus
- End of Life, Brain Death and Organ DonationSymptom control and the ethics of comfort: Opioids are the mainstay for pain and dyspnea. Truog 2008 names morphine the agent of choice, with fentanyl (by infusion, since a bolus wears off quickly) or hydromorphone as alternatives. Benzodiazepines add anxiolysis, sedation and amnesia but no analgesia; midazolam peaks in 5–10 minutes, lorazepam in 20–25. When distress recurs, bolus and raise the in
Practice Sedation, Pain and Delirium Scales questions free123 exam-style questions with rationales on the topic where hydromorphone comes up most. No account or download needed.
Other sedation, analgesia and paralysis
- Propofol
- Dexmedetomidine
- Midazolam
- Fentanyl
- Cisatracurium
- Ketamine
- Rocuronium
- Vecuronium
- Pentobarbital
- Remifentanil
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For education and exam preparation only. Follow your institution’s protocols. Study aid: check every dose against the order, the bag label, your pump library and your institution's protocol.