Narcotic Equivalents |
||
Analgesic |
Oral Dose (mg) |
Parenteral Dose (mg) |
Meperidine (Demerol) |
150 |
50 |
Codeine (Tylenol #3 x3) |
100 |
60 |
Hydrocodone (Vicodin x3, Lortab x3) |
15 |
N/A |
Morphine (MSIR, Roxanol) |
15 |
5 |
Oxycodone (Percodan x2, Percocet x2, Tylox x2) |
10 |
N/A |
Methadone (Dolophine) |
10 |
5 |
Hydromorphone (Dilaudid) |
4 |
0.75 |
Levorphanol (Levo-Dromoran) |
2 |
1 |
Fentanyl |
N/A |
0.05 |
Steroid Equivalents |
|
Steroid |
Dose (mg) |
Cortisone |
25 |
Hydrocortisone |
20 |
Prednisone |
5 |
Prednisolone |
5 |
Methylprednisolone (Solu-Medrol) |
4 |
Dexamethasone (Decadron) |
0.75 |
Vaccine |
Who |
What |
Contraindication$ |
Pneumovax |
>65, Q5 yrs Chronic disease*, aplenia, alcoholism |
Polyvalent 23 capsular polysaccharide antigens |
Pregnancy |
Influenza (Oct-Nov) |
>50, Q1 year Chronic disease* Nursing home resident |
Inactivated virus |
Prior Guillain-Barre from flu shot |
Tetanus-diphteria (Td) |
Q10 years OK in pregnancy |
Tetanus and diphteria toxoids Primary series 0, 1, 6 months then Q10 year booster |
Td preferred over Tdap in pregnancy |
Tetanus-diphteria-pertussis (Tdap) |
Once as adult- alternative to Td as gives protection for pertussis as well |
Tetanus and diphteria toxoids |
Severe latex allergy Epilepsy Prior coma or seizure with DTaP as child |
Measles-Mumps-Rubella (MMR) |
Persons born 1957 ot later, consider in immigrants with no history. Health care workers, international travelers may need 2nd dose |
Live attenuated virus |
Pregnancy or possible pregnancy within 3 months Immunocompromised Recipients of blood products or immune globulin in past 11 months |
Varicella |
All adults who are not immune (can ask history or check titers if unsure) |
Live attenuated virus Two doses 4-8 weeks apart |
Pregnancy or possible pregnancy within one month Immunocompromised, active untreated TB, received blood products in last 6 months, lymphoma/leukemia |
Zostavax |
Age >60 years One time dose |
Live attenuated |
Immunodeficiency, lives with patient who is immunocompromised, pregnant, active tuberculosis, high dose steroids, anaphylactic rxns to gelatin, neomycin or components of vaccine |
HPV |
Currently recommended for girls age 11-12. Catchup vaccine for girls 13-26 |
Inactivated virus Three doses at 0, 2, 6 months |
Pregnancy |
Meningococcal |
Dose at high school entry, dormatory living, military recruits, aplenia, exposure, international travel |
Polysaccharide vaccine Conjugate vaccine (preferred) |
Unclear in pregnancy Prior Guillain-Barre |
Hepatitis A |
Liver disease**, IVDU, MSM Planned travel outside US |
Inactivated virus Two shots 6-12 months apart |
Unclear in pregnancy |
Hepatitis B |
Liver disease**, IVDU, MSM, STD risk factors, healthcare worker, renal disease, prison inmate, internation travel, household contact |
Recombinant DNA Three doses at 0, 1, 6 months |
|
*Diabetes, COPD, heart dz, kidney dz, sickle cell, HIV, cancer, pregnancy, steriod use, lives w/ at risk person **Chronic liver disease, HCV, HBV, clotting disorder $Anaphylaxis to vaccine or components is contraindication to any vaccine |
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