MEDICATION KINETICS
Equivalent Dose
Elimination t ½
Generic Name
T Cmax
Elimination t ½
Generic Name
T Cmax
STEROIDS
LAXATIVES Bisacodyl (stimulant) aka Ducolax
Initial response PO: 6–12 hrs PR: 15–60 min
PO tabs/elixir: 1 hr (1–2) SC/IM: 30 min IV: 15 min (6–15)
NA
Dexamethasone EM (effect follows biological t ½ , not plasma t ½ )
Plasma: 2 hrs (1.8–3.5) Biological: 36–54 hrs
0.75 mg
Docusate Na + or Ca ++ (surfactant) EM aka Colace (Na + ), Surfak (Ca ++ )
Initial response PO: 1–3 days
NA
Prednisone
Glycerin (irritant)
Initial response PR: 15–30 min
NA
Plasma: 2.5 hrs (2–3) Biological: 18–36 hr
PO: 1.5 hrs (1–2)
(effect follows biological t ½ , not plasma t ½ )
5 mg
Lactulose (osmotic) EM aka Kristalose, Enulose Magnesium citrate (osmotic) Methylnaltrexone (peripheral opioid m μ receptor antagonist) aka Relistor
Initial response PO: 24-48 hr
NA
Prednisolone
PO: 1 hr
Biological: 18–36 hr
5 mg
Initial response PO: 0.5–3 hr
NA
PO: 1 hr IV: 30 min
Methylprednisolone
Biological: 12–36 hr
4 mg
SC: 30 min
SC: 2 hrs
Hydrocortisone
PO: 1 hr
Biological: 8–12 hr
20 mg
Polyethylene Glycol aka PEG, MiraLAX Psyllium (not absorbed) aka Metamucil
Initial response PO: 24-72 hr
NA
aka = also known as IR = Immediate Release ER = Extended Release EM = Essential Medicine as defined by WHO and IAHPC SC dosing is preferable over IM dosing Avoid medications with short half-lives in patients with short life expectancy who may experience withdrawal when these medications are stopped at end of life. Medication Information Sources Micromedex Healthcare Series, Truven Health Analytics Inc. 2012-2014 Clinical Pharmacology, Elsevier/Gold Standard 2013. Goodman & Gilman’s The Pharmacological Basis of Therapeutics, Twelfth Edition, McGraw-Hill Medical Publishing Division, 2011. American Hospital Formulary Service (AHFS) Drug Information, 2012. American Society of Health-System Pharmacists, Bethesda, MD
Initial response PO: 12–24 hrs (up to 3 days) Initial response PO: 6–12 hr PR: 0.5 –2 hr
NA
Sennosides (stimulant) EM aka Senna Sodium phosphate (osmotic) aka Fleets
NA
Initial response PR: 0.5–3 hr
NA
Sorbitol (osmotic)
Initial response PO: 0.5–3 hr
NA
63 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
T O C
Made with FlippingBook interactive PDF creator