DOSING‒FIRST ORDER KINETICS
Most medications to manage symptoms follow first-order kinetics, i.e., clinical effect follows the plasmaconcentration
IV
Dose scheduled medications every t ½ Steady state is reached after 5 x t ½ Dose breakthrough medications every T max PRN Choose 10‒20 % of 24 hr dose
SC / IM
PO /PR
Cmax
Opioids t Cmax
t ½
IV
15 min 4 hr 30 min 4 hr 60 min 4 hr
SC / IM PO / PR
0
T max
Half-life ( t ½ )
Time
11 NB: These Reference Cards do not replace careful clinical judgment specific to each patient / family situation. PCIC: Palliative Care Interdisciplinary Curriculum is a collaborative effort of OhioHealth, The Ohio State University Wexner Medical Center, and Nationwide Children’s Hospital in Columbus, Ohio, USA, and other contributors. Permission to reproduce any or all of these PCIC Reference Cards is granted for non-commercial educational purposes only, provided that the attribution statement and copyright are displayed. To reproduce for all other purposes, contact Frank D. Ferris at info@pallmed.us. Copyright © Frank D Ferris 2013-2024. All rights reserved. V14.1, 2024 See Medication Kinetic Parameter cards for T max and t ½ for selected palliative medications
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