hydromorphone

Indication

A narcotic pain medication used to relieve pain.

Side effects

Sedation, decreased senses, dizziness, seizures, euphoria, low blood pressure, decreased heart rate, nausea, vomiting, constipation, ¯ paralytic ileus, urine retention (cannot void), respiratory depression (slowed breathing), and addiction.

Interactions and precautions
1. Use with alcohol tricyclic antidepressants, sedatives, other narcotic pain medications, antihistamines, muscle relaxants, or other depressants can increase sedation.
2. Use with anticoagulants; (Warfarin) may increase anticoagulant effect.

Usual dose

Adults: oral, 2 mg every three to six hours as needed. Paediatrics: individualized by physician.

Deep Venous Thrombosis

Deep Venous Thrombosis is a condition wherein a blood clot develops in a deep vein that accompanies an artery, mostly in the lower limbs. Consequently, the clot affects blood circulation. Usually thrombosis sets in when the coagulation function is impaired or imbalanced due to abnormalities in the blood, altered blood flow or damage to the blood vessels. Typically the main veins affected by deep venous thrombosis are inner thigh, calf, groin and lower abdomen. A person suffering from deep venous thrombosis is likely to experience pain and swelling in the affected limbs. The pain in the affected leg can become so severe that the person is unable to bear weight on it. This condition is different from arterial thrombosis where the clot forms in the arteries. The main risk factor associated with deep venous thrombosis is that the clot may break off and travel along the blood stream to lodge itself in the lungs, heart or brain. This disease is usually noticed in adults over 60 years.

Deep venous thrombosis is brought about by reduced blood flow or thickening of the blood. Persons who have undergone surgery and been given anti-clotting drugs are likely to develop this condition. Long car or plane journeys, fractures, birth control pills and surgery are potential conditions that may lead to this disease. Those with a history of polycythemia vera or hypercoagulability are more likely to suffer this condition. One of the potential dangers of deep venous thrombosis is pulmonary embolism. Pulmonary embolism is a serious, life-threatening condition where the embolism blocks or closes the artery in the lung. Another complication of deep venous thrombosis is post-thrombotic syndrome characterized by edema, hyperpigmentation and skin ulceration.

Some of the diagnostic tests that help detect deep venous thrombosis are ultrasound Doppler, venograpy of the legs and D-dimer blood test. The Doppler ultrasound aids in studying the reduced blood flow in the affected limbs. The venogram is a special x-ray that reveals any blood clot that is responsible for obstructed blood flow. The blood tests can reveal the clotting tendency. Heparin is an anticoagulant that has been intravenously given to a patient along with oral warfarin. These medications cause an increase in clotting time. But careful monitoring is of the essence so as to avoid risk of haemorrhage.

Cardiac Arrhythmia

Cardiac arrhythmia refers to a disturbance of the heart rhythm. When the regular heart rhythm is disturbed, it can lead to symptoms that can range from mild to life-threatening. The heart may have slower beats or there may be a blockage of the electrical pathway of the heart. One of the most common form of cardiac arrhythmia is atrial fibrillation. This occurs in older persons when the upper atrial chambers of the heart do not pump correctly. This can lead to blood clots. Heart failure or electrolyte imbalance can bring on cardiac arrhythmia.

Tachycardia is a condition where there is rapid heartbeat due to inefficiency in the blood circulation. Tachycardia is a condition where the heart rhythm is more than 100 beats/minute. This can happen due to stress, hyperthyroidism or alcohol. On the other hand, Bradycardia is a condition where the heart rhythm is less than 60 beats/min. A ventricular arrhythmia can be life-threatening. This happens when there is ventricular fibrillation. It is essential to treat this condition and restore the rhythm within minutes to prevent heart damage and death. Allergic reactions can trigger arrhythmias.

Some persons suffering from cardiac arrhythmia notice symptoms such as dizziness, fainting and lightheadedness. There may be a fluttering or pounding sensation in the chest. Antiarrhythmic agents such as amiodarone and sotalol are prescribed to maintain the normal rhythm of the heart. In cases of atrial fibrillation, warfarin is used to prevent blood clots. Medication for cardiac arrhythmia includes beta blockers such as metoprolol and atenolol to reduce the heart rhythm. An electronic cardiac pacemaker may be implanted to regulate the heart beat.