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Childhood Leukemia

Drugs Used to Relieve Pain


The following excerpt is taken from Chapter 10 of Childhood Leukemia: A Guide for Families, Friends, and Caregivers, 3rd Edition by Nancy Keene, copyright 2002 by O'Reilly & Associates, Inc. For book orders/information, call (800) 998-9938. Permission is granted to print and distribute this excerpt for noncommercial use as long as the above source is included. The information in this article is meant to educate and should not be used as an alternative for professional medical care.

As with other drugs, drugs used for pain relief can be given by various methods and can cause side effects. This article lists some drugs commonly used to relieve pain. Many other medications are used to relieve pain in children, including Tylenol, Nalbuphrine, Fentanyl, Hydrocodone, and others.

Pain medication list

Several different names can be used to refer to each of the pain medications. You may hear the same drug referred to by its generic name or one of several brand names, depending on which doctor, nurse, or pharmacist you are talking to. The list below gives various names of pain medications, and what name to look under in this article.

Name: Look Under:
Codeine Codeine
Demerol Meperidine
Dilaudid Hydromorphone
Dolophine Methadone
Methadone Methadone
Morphine Morphine
Percocet Oxycodone

Codeine

How given: Intramuscular injection, pills by mouth, liquid by mouth

How it works: Codeine is an alkaloid obtained from opium.

Common side effects:

  • Light-headedness
  • Dizziness
  • Sedation
  • Euphoria
  • Constipation

Infrequent side effects:

  • Nausea
  • Vomiting

Meperidine

Also called: Demerol

How given: Intravenous injection, liquid by mouth, pill by mouth

How it works: Meperidine is a narcotic similar to morphine.

Common side effects:

  • Sedation
  • Constipation

Infrequent side effects:

  • Dizziness
  • Nausea and vomiting
  • Sweating
  • Rashes
  • Respiratory depression
  • Decreased blood pressure
  • Seizures
  • Headaches
  • Visual disturbances

Hydromorphone

Also called: Dilaudid

How given: IV injection, pill by mouth, rectal suppository

How it works: Hydromorphone is a narcotic pain reliever.

Precautions: Hydromorphone can cause respiratory depression.

Common side effects:

  • Light-headedness and dizziness
  • Sedation
  • Nausea
  • Vomiting
  • Sweating
  • Euphoria
  • Alterations of mood
  • Headache
  • Respiratory depression

Infrequent side effects:

  • Circulatory depression
  • Hallucinations and disorientation
  • Respiratory arrest
  • Shock
  • Cardiac arrest

Methadone

Also called: Dolophine

How given: IV injection, pill by mouth, liquid by mouth

How it works: Methadone is a narcotic pain reliever.

Common side effects:

  • Light-headedness and dizziness
  • Sedation
  • Nausea and vomiting
  • Sweating
  • Euphoria
  • Anorexia (loss of appetite)

Infrequent side effects:

  • Respiratory depression
  • Circulatory depression
  • Shock

Morphine

How given: IV injection, pill by mouth, liquid by mouth

How it works: Morphine is a narcotic derived from the opium plant.

Common side effects:

  • Euphoria
  • Nausea and vomiting
  • Drowsiness
  • Constipation

Infrequent side effects:

  • Reduction in body temperature
  • Respiratory depression
  • Allergic reactions, including hives
  • Seizures

Oxycodone

Also called: Percocet, oxycotin

How it works: Oxycodone is a narcotic derived from opium.

Common side effects:

  • Light-headedness
  • Dizziness
  • Sedation
  • Nausea and vomiting

Infrequent side effects:

  • Respiratory depression
  • Skin rash

Local anesthetics to prevent pain

Two products commonly used to prevent pain are EMLA and Numby Stuff.

EMLA cream

How given: Applied to the skin and covered with an airtight dressing one to two hours before procedures such as spinal tap, bone marrow aspiration, or injection.

How it works: Emulsion which contains two anesthetics, lidocaine and prilocaine.

Note: May take longer than an hour to achieve effective anesthesia in dark-skinned individuals.

We use EMLA for everything: finger pokes, accessing port, shots, spinal taps, and bone marrows. I even let her sister use it for shots because it lets her get a bit of attention, too. Both of my children have sensitive skin which turns red when they pull off tape, so I cover the EMLA with plastic wrap held in place with paper tape. I also fold back the edge of each piece of tape to make a pull tab so the kids don't have to peel each edge back from their skin.

Numby Stuff

How given: Needle-free method of delivering pain medication through the use of low-level electric currents applied to the skin.

How it works: Emulsion which contains two anesthetics, lidocaine and epinephrine.

Note: Anesthetizes skin and tissue in ten to fifteen minutes. Some children and teens do not like the electrical sensation that goes from the site to the battery pack.


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