Doctor insights on:
Narcotics And Elderly
Can older people safely take opioids, such as hydrocodone (Vicodin) and oxycodone (Percocet), to manage arthritis pain?
An opioid isn't the first choice for treating chronic conditions such as arthritis: Aside from cancer pain, opioids more commonly are reserved for short-term pain relief, such as after injuries or surgeries. When other means of relieving arthritis pain haven't helped, opioids may be prescribed. But safety and effectiveness are issues. Opioids may not be helpful. Even when they are, people often develop a tolerance to opioid pain medications over time, so the effect of the medication may diminish after taking the same dosage for several months. Opioids have risks that may be particularly serious for older people, including: Sedation. , Disordered breathing. , Heart problems. , Constipation. ...Read more
A natural or synthetic alkaloid compound that has morphine-like qualities. Other examples are codeine, heroin, Meperidine (demerol). They are classified based on their intrinsic activity & where they interact in the central nervous system. They are involved in pain transmission ...Read more
For symptom relief: Anyone of any age who has dementia can suffer from fearfulness, paranoia, hallucinations, delusions and other psychotic symptoms. Antipsychotic medications can be the most effective way to minimize or eliminate these symptoms and the suffering they cause. Use of any medication for any illness should be preceded by a discussion of risks and benefits. ...Read moreSee 1 more doctor answer
No: Only a small percent of people actually get addicted to narcotics, but most who are on it chronically are dependent. The difference is that addiction is characterized by the continued use of a substance despite adverse consequences. The goal of chronic pain medicine is not to take the pain away, but to increase the function of the individual, so you can do more. ...Read moreSee 12 more doctor answers
Usually safety issue: Preferable to use restraints than have an elder fall out of bed or chair or go wandering off and find themselves in dangerous situations. Most hospitals and nursing homes do not have enough staff to have one on one caretakers all the time. Restraints are thus often necessary for economic reasons. Abuse would be the use of restraints purely as a punishment. ...Read more
Is risperdal .5 mg dose safe for an elder patient with alzheimer's and vascular dementia? I read this drug can cause sudden death in elder patients.
No: According to all studies so far, any antipsychotic used for the purpose of treating behavioral problems or psychosis related to dementia is associated with earlier stroke-related death. This occurs regardless of the antipsychotic and the dose. There are some studies that have shown some antipsychotics to be safer than others (like quetiapine) but those studies are small and inconclusive. ...Read moreSee 1 more doctor answer
Butrans & buprenex (buprenorphine): Intravenous Buprenorphine (buprenex) initially gained fda approval in the us as an analgesic agent. Recently, a trandermal patch (butrans) was approved. The oral formulation does not have a fda indication as of yet. On a case by case basis, a doctor can decide if opiates are even appropriate for the chronic pain & bup may be a good option due to its ceiling effect. ...Read moreSee 1 more doctor answer
If it is prescribed: specifically by your doctor, then the answer is yes. The danger of self-medicating with these substances is the potential cumulative and synergistic effect with potentially serious or life-threatening side-effects. ...Read more
Yes but...: Yes but even more important is the fact that you can become habituated and physically dependent of these drugs. This means that larger doses will be necessary to achieve the same effect as previously achieved with lower doses. There also can be serious withdrawal symptoms. Using these medications should be under the close supervision of a physician. ...Read moreSee 1 more doctor answer
Duragesic (fentanyl): The label states that its for adults only. Anyone above the age of 18yrs ...Read more
All? No: We're all individuals so there's no blanket need for drugs for everyone, although it might seem as if every elderly person is taking aspirin & statin. But there are no drugs per se for weight, unless you're thinking of weight loss drugs or appetite stimulants (which we don't recommend). There's a greater tendency to higher blood pressure w/age but not everyone needs drugs. In fact, we've raised BP ...Read more
History of ponv with both general and spinal anesth w/morphine and highly opiate intolerant. What anesth options are left for total hip replacement?
Hip fracture: You seemed to have experienced hypotension and pov from Morphine Sulfate and inhalational agents. Your anesthesiologist can use a continous lumbar plexus block and total intravenous anesthesia. If they are not good with regional techniques , use inhalational agents with a cocktail of antiemetics : scopolamine patch , promethazine/inapsine/zofran and adequate hydration. Good luck. ...Read moreSee 7 more doctor answers
Can inderal, (propranolol) once prescribed and tolerated, suddenly cause confusion in an elderly patient post infection?
Long term effects: Analgesic tolerance means decreased analgesic effect in long-term opioid treatment and the patient needs higher doses to experience the same effect. Physical dependence is actual change in physiologic response, i.e. If the patient stops the substance, the withdrawal signs will appear. Psychological dependence is some kind of perception which patient feels his well-being is from that substance. ...Read moreSee 1 more doctor answer
Avoid dry mouth se: If dry mouth is on the side effects listed consult your pharmacist or physician before taking it. The medicine gaufenesin can help unclog and loosen mucus from congestion. Asking the pharmacist to help you while mentioning you want to avoid anything anticholinergic. Also if there are problems after something is taken avoid that in future. ...Read moreSee 1 more doctor answer
Yes: It is an excellent choice for elderly people with or without vascular dementia who have sleep onset insomnia. It does not have the high fall risks associated with the other sedative hypnotics. It also can strengthen the circaidian rhythm that is weakened in dementia patients. ...Read moreSee 1 more doctor answer
If endorphins bind to opioid receptors then why don't they cause nausea and vomiting like opioid painkillers such as morphine?
Suffer from MS use Valium for spasms and hydrocodone for severe pain as needed. Can I take both together??
Yes, but: The two together will cause additive sedation, dizziness, and could cloud your sensorium and judgement. If your spasms are due to spasticity, baclofen, or tizanidine might work better, and Botox could be considered. If your spams are due to neuronal short circuiting, an anti-epileptic drug might be used. Have you been assured by your neurologist of the cause of your spasms?? ...Read moreSee 1 more doctor answer