Typical PCA orders and dosing for hydromorphone

  • PCA dose 0.2 mg
  • Lockout interval 8 minutes
  • Maximum Limit (per 4 hours) 4.5 mg
  • continuous infusion amount 0 mg per hour
  • --These doses are an example only and should be adjusted based on the situation--

Malignant Bowel Obstruction Protocol

  • Consider NG tube if distension or frequent emesis
  • Rehydrate and correct electrolyte imbalances
  • Consider Corticosteroids: Dexamethasone 4 mg sc/iv BID-QID with Randitidine 50 mg IV q8hours
  • Antiemetic: If incomplete obstruction: use a prokinetic (metoclopromide)
  • Antiemetic: If complete obstruction: use a neuroleptic (halperidol OR prochlorperazine)