Opioids dilaudid vs. oxycodone

so somebody in my family is in the hospital for cancer its stage 3 but they have never taking opiates but they are experiencing bad pain the drs. have been making horrible decisons like for real im just amazed at what they have been doing for 3 weeks... Bu they have been i.v.'ing him dilaudid like 4 mL and he just passes out they were giving him fentanyl in the begining but that was bad bad then they moved to dilaudid... And like i said the ROA is I.V. thats been for the 3 weeks now they wanna give him 10 mg of oxycodone oral... Is it just me or is that not even gonna help him since the dilaudid is main lined and instant release, the oxy wont even touch him since its 10 mg over what 12 hrs..shouldnt it be a little more im just curious becasue they have gave him numerous medications and they all have been horrible and i said they would do nothin but make it worse, and thats exactly whats been happening... Sorry if its hard to follow and i can give me details if needed

How many mg/ml was the hydromorphone? 10mg of oxycodone doesn't seem like a significant amount for analgesia, esp. after gaining slight tolerance from multiple weeks of fentanyl/hydromorph administration. ESPECIALLY for severe cancer pain.

You'd be surprised. The opiate naive often come home from spending quite some time on IV dilaudid, morphine after major operations, accidents, etc, only to be switched over to oral tylenol hydro/oxy preparations and respond very well. 3 weeks w/ such a short acting ROA hasn't been enough to establish a tolerance like you're thinking he's going to have.
I hope that you aren't the one hoping that they come home with something stronger.

hes still in the hospital and it has never helped his pain they are always late with his medication and he goes into slight withdrawl but his kidneys are only functioning at 4 percent to and all i know is 4 ml i dont think i can find out either.. all i know is how he has been responding to each thing they have been giving him..and really who the fuck are you to even come at me..come home with somethin stronger..? yea you could have done without that bullshit you should learn some fucking respect

I don't think he was accusing you or meant to be disrespectful.

Anyway, he should talk to his primary care physician or maybe a pain management doc and tell him that what he has just isn't doing it. Maybe he should get some OxyContin in the 40mg range perhaps. My only advice is to just talk with the docs and tell them he is still in serious pain and what they are doing is not effective enough.

that was a somewhat disrespectful comment though. I'd say they are obviously concerned about the well being and comfort of their loved ones

honestly your doctor is probably thinking those oxy 10s are a significant dose, if he hadn't been on IV dope so long he probably would have only gotten 5s. you know how doctors are- a hydro 7.5 is "heavy duty"

^This is true, I guess doctors only go high up in dosages for seriously tolerant patients.

ya i dont think they are doing it on purpose its just that its my grandpa and hes in stage 3 multiple myeloma and his kidneys are only functioning at like 4 percent or thats what it was a week and a half ago...and i havent been down there much and everything that i have said or advised is what helped him.. And yes most doctors are naive when it comes to stuff like them thinking hydrocodone is strong and things like they thought ppl couldnt withdrawl from suboxone they can just be naive sometimes but hes hanging on by a thread and i dont want them making a whole bunch of mistakes like they have been

wouldnt hospice show up at home to administer "treatment"my g-ma had a huge tumor on her cervix and caused bowel obstruction she was givin perc 5's ,she couldnt keep her sugar pill down and went into shock? i think

she went to hospital they gave her a shot (insulin) and she was wide awake talking etc,we left the hospital, when she came home the next day she was fucking nodding,they slapped on a 100mcg fent patch ...!!?? i mean she was fucking OUT ...the next day she died!!!!

they said she had 6 months or so a week before this

now she wouldnt even ask for the percs ,said tylenol helped just fine ..that means NO TOLERANCE at all

im pretty sure they thought the "dope" made her comfy but i was so fucking mad cuz i know thats what killed her,they said the tumor was inoperable but i think she woulda wanted to say good bye not unconscience in her last moments ,or comfy not drooling,when your that fucked up u arent conscience anyway... man it still angers me

To the OP, 10mg of OxyContin does seem a bit light after IV dilaudid. I may be incorrect, but I know when I received dilaudid shots in the hospital, they were 2mg prepared in 1mL solution, so it's possible that he's been receiving 8mg of dilaudid. Though when I think about it that seems like a lot, it could just be 2mg in 4mL.

Anyway, I agree with ohayou about seeing a pain management doctore and getting OxyContin in dosages of 40mg or stronger. Opana ER would probably work really well too, and you're friend could probably do pretty good on just 20mg oral. I empathize with the situation. I was in a hospital for a month, and the doctors and nurses were always late with my pain medication, and even later when I switched back to suboxone. Originally they didn't even want me to go back on the suboxone, explaining that buprenorphine isn't a real opioid so it won't produce withdrawals.

i prefer dilaudid personally

geriatric_pornstar said:

i prefer dilaudid personally

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Yeah don't think that's the concern here.

Why didn't they just give the low dose of oxy to begin with?

ok so ill explain a little better now the problem is its not that i want to be right i just love my grandpa and dont want the see the strongest man i ever met hurt... Now they started off at 25mcg of fentanyl that made him delerious and i told them that plus i told them i had a feeling that he was like me and ativan would freak him out and it did, so hes all deliours talking crazy shit saying he wants to just die... So i say no more fentanyl or ativan so what do they do they up both fentanyl to 50mcg and it gets o so worse those were the first couple of weeks maybe week and half... I finally after pretty much a power point presentation convince them to try something else so they go w/ dilaudid which just makes him pass out now during all this he hasnt ate or anything and nobody listens to me on what HE actually needs to feel better... Just a couple days ago they got on page with me with the rest of my advice... People are making him eat and about to switch medications again thats why they are going to the oral 10 mg oxy and ive been thinking the whole time he needed to be regulated on something good for him that his body accepts... But by them being naive my gpa has went trough 3 weeks of hell and everyday he starts to slightly W/D they say they want to ween him off of dilaudid but they arent instead just 10mg oxy oral in the morning and still gettin dilaudid every 2-3 hrs... I say lets do 40mg oxy oral and start spacing out the dilaudid by skipping and lowering the dose... I just dont think they are making the best decisions cuz he had never taking pain meds and when they put him in they started way to high and have awakened the addict in him you can tell and now they want to drop his shit and put him in W/Ds while hes in stage 3 multiple myeloma and his kidenys are functioning at less than 5%, get real... Im sorry for ranting its just anybody with knowledge about this kinda stuff would be mad cuz their just making it worse and also i apologize if its kinda hard to follow i have a hard time putting my thoughts on paper and thank you for your concern and input

I hope you are being eloquent with your "recommendations" as to what Meds the hospital should be giving your Grandpa. Doctors don't like being given medical advice on how to treat their own patients whether you have his best interests in mind or not. On the flip side you have the nurses who can't illicit any change to treatment themself, rather must OK it thru the treating Doc, and Nurses are so used to the family coming up with their own diagnosis's and presenting "new" problems, that you have to be careful how you bring it up. Nurses are also not pain specialists. That also goes for most hospital Docs. They treat ACUTE pain, and you throwing around Oxycontin 40mg is something never Rx'ed by a hospital Doc. His job is to treat the acute pain, and by trying to get your grandpa on 10mg of percocet -- he's actually maxed out what he can do for him in terms of take home pills. If you feel like this wont be enough, then talk to his Doc about making sure he gets a pain clinic referral ASAP to be seen before his Perocets run out.
Old people are tougher than us, btw. They've been through hell. Once he's out of the hospital, why dont you re-evaluate his pain score. I think it's admirable that you want to help him, obviously you care for him. Obviously you also have a strong interest in opiates, so you've been exposed to a lot of forum convos and wiki-esque research. Realise what you know is WAYY more than even the Average Physician knows, who again - are there to treat Acute Pain (Fentanyl, Dilaudid, percocet). You may be right, but I imagine you're barking up the wrong tree. The hospital probably has access to OxyContin to provide to patients who come in who are already Rxed this med - but you wont find a Doc at that hospital, outside of a pain clinic, to write a new prescription for it.
Good luck, I hope the best for your grandpa.

I had NO, ZERO, NADA intention of sounding like a Dick in my previous post. Do you know how many people steal meds from family? My wife had her Oxycodone stolen by her teenage sister the same evening she was released from the hospital following a fucking Spinal Fusion. Plus, you're at a drug forum. Not a pain forum. A forum people come to discuss the use and abuse (with harm reduction in mind) of drugs to get high. The question had to be asked. It was of no personal meaning.

you know, reall, IMO...Let your grandpa be the one to evaluate his pain level after hes out of the hospital. Again, i know you're anxious to help him by using knowledge in an area that you feel like you know a lot about. But at the same time, get that referral to a pain clinic for your G-Pa, and have it on the books prior to his meds running out.
One step at a time here.

Another thing you should take into consideration is hospitals take their fucking time, they come up with a plan and it could be a day or two before they start it! thy tell you you are being discharged at 8am, and you don't get your papers until 4pm. Assholes.

Anywhom, another thing to remember is that drs aren't going to start off with 40mg of Oxy, like reversible mentioned. They want to treat with the lowest possible dosing that the patient can tolerate, IME. So they'll start with something low, try it for a day or two, and they'll insist you try it, while you sit there and suffering, and then ask you how its working a day or two later and you say it's not, then they make the decision to go up, and even that will take time! It's ridiculous, but that's how it is, IME..

Good luck and I hope the best for your gramps. I know what it's like watching someone you love dying from cancer. My mom died from Cervical cancer, tho my rather and I had no idea she was drying, she never told us

Yea, I admire also, the way your into helping your G-Pa, who probably half of people on this forum didn't even know their g-pa, g-ma or mom or dad for that matter...but damn I did know G-Pa had some great pills he left behind.

Don't try to act like you know more than docs, who went to school for 10 or so years and THINK they know what they're doing. It sounds like that's what your trying to get us to do for you, in a very sneaky way. no Offense
GET RIGHT
KNOW YOUR ROLL
Your a very nice Grandson that has no idea about Opiates, but does know G-pa is in alot of pain and you care so so so much...Hows your liar skills?

I don't get how you can tell hes in more pain than him telling the doctors, do you know something he doesnt?

Fuck, If I where you, I couldn't wait till good ol G-Pa came home with a bunch of Opanas that I could take here and there without any notice....Why don't you just let the nurses and docs do their job, if you call it a job...and then when your g-pa is out, you can admin the drugs for him...or is that the problem, you don't have the drugs to admin so you want to know how to get them...its a perfect scenario, I mean he is in a hospital with serious pain....

But don't fret, almost all G-pas, and G-mas are in pain...it is sad....but its sadder that their lil grandsons want their dope. Fuck, I feel bad for takin my dads shit when he DIED. I still did it, and Im sorry for it...but shit, it is what it is homie...and Dont get mad at people for saying this...its just what ALOT of people do, you shuld know that, your smart enough.

-Play Safe

already thanks for your concerns but i aint told the drs. anything or the nurses instead ive just told my family so they could say something i already knew they wouldnt want to hear it from me... And i dont want 40 mgs but they raised his tolerance from NONE IN HIS LIFE EVER to the hight amounts they were adminstering and now after 3 weeks they want to lower it which means he is in extra pain thats what im gettin at... All i was getting at was whats already been answered that 10 mg oral oxy is not sufficient after 3 weeks of a considerably high dose of fentanyl and then also I.V.'d dilaudid which was probably around 8mg for that 3 weeks also

You know, terribly sorry.. I read it backwards, I wicked am sorry. But I did say In My Experience, 3 weeks wasn't long enough to grow tolerance.. I wasn't stating facts, just my own experience, you can't get mad for me stating what I've been through.. It's what your asking for.

do you not fuckin read or can you just not comprehend what im saying this shits past old if you aint gonna read the whole thing or dont know what the fuck your talkin about dont speak on it... A) 3 weeks is plenty of time to get dependent B) im not even talking about his pain im getting at the fact that they are making him miserable C) where did you get hes on 40 mgs of oxy..? because i believe i said numerous times its 10 mg oral and the man is sick all day long until they finally give him dilaudid.. Im so pissed dealin with stupid disrespectful ppl like you i wish somebody would come at me like this in person