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Sedation/Analgesia, PICU, Mechanically Ventilated Patient — Opioid Rotation — Clinical Pathway: ICU

Sedation/Analgesia, Mechanically Ventilated Patient Clinical Pathway — PICU

Opioid Rotation

  • All conversions are not intended to be bidirectional
  • Conversions incorporate a dose reduction for incomplete cross-tolerance
  • Avoid recommending rotation back to fentanyl due to tachyphylaxis
Fentanyl
Rotation to Morphine
Fentanyl ___ mcg/kg/hr x 0.02 = __ mg/kg/hr IV morphine
Rotation to Hydromorphone
Fentanyl ___ mcg/kg/hr x 0.005 = __ mg/kg/hr IV hydromorphone
Hydromorphone
Rotation to Morphine
Hydromorphone ___ mg/kg/hr x 5 = __ mg/kg/hr IV morphine
Rotation to fentanyl
Do not convert
Morphine
Rotation to Hydromorphone
Morphine ___ mg/kg/hr x 0.12 = __ mg/kg/hr IV hydromorphone
Rotation to fentanyl
Do not convert

 

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