HYDROmorphone: Balancing the Benefit and Risk for Patient Care
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HYDROmorphone: Balancing the Benefit and Risk for Patient Care
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HYDROmorphone: Balancing the Benefit and Risk for Patient Care
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 HYDROmorphone: Balancing the Benefit and Risk for Patient Care


While the use of meperidine (Demerol ®) has steadily decreased in healthcare settings, the use of HYDROmorphone (Dilaudid®) for the management of acute pain has become more commonplace. This increase in use, however, has not come without consequences to patients as evidenced by an increase in reported medication errors and serious adverse drug events. Errors with HYDROmorphone have led to allergic reactions, failure to control pain, over-sedation, respiratory depression, seizures, and death.  These events are primarily due to misunderstandings of equi-analgesic dosing by practitioners, as well as and well as inappropriate monitoring and reassessment of patients. In addition, ISMP has received many reports of confusion between HYDROmorphone and morphine. Mix-ups between these high-alert drugs are extremely common and serious sometime fatal events have occurred. 

Join ISMP experts as they identify common types of errors that occur with HYDROmorphone, and barriers to optimal therapy, as well as provide insight into seldom used methods of risk identification and high-leverage strategies that can be immediately implemented to identify a problem as well as reduce patient harm.

The following topics will be discussed:

1. Prescribing of HYDROmorphone including;

  • Patient assessment/screening
  • Dosing errors with IV HYDROmorphone
  • Ordering of multiple medications with sedative properties
  • HYDROmorphone PCA

2. Mix-ups with morphine products including

  • Look- and sound-alike drug names
  • Mistakes due to similar labeling and packaging
  • Drug storage issues

3. Challenges for nurses associated with HYDROmorphone use

4. Risk identification methods used specific for HYDROmorphone  including the use of adverse drug reaction (ADR) reports to uncover preventable events with HYDROmorphone

5. Use of reversal agents

6. Risk reduction strategies for patients receiving HYDROmorphone

7. Measures to evaluate the safety of opiate use

INTENDED AUDIENCE (Interdisciplinary teams are encouraged to attend together):

  • Physicians
  • Nurses
  • Pharmacists
  • Physician Assistants
  • Nurse Practitioners
  • Risk and Quality Managers
  • Medication Safety and Patient Safety Officers
  • Pain teams


Following completion of this webinar, participants should be able to:

  • Describe common preventable adverse events with HYDROmorphone and their causes
  • Identify best practices that can improve safety when prescribing, dispensing, and administering opiates
  • Discuss the role of monitoring and managing the care of patients who are receiving HYDROmorphone
  • Construct process and outcome measures that can used to assess the safety of HYDROmorphone therapy


Matthew Grissinger, RPh, FISMP, FASCP
Director, Error Reporting Programs
Institute for Safe Medication Practices
Horsham, PA

Susan Paparella, RN, MSN
Vice President
Institute for Safe Medication Practices
Horsham, PA


You may return most items sold by ISMP within 30 days of shipping for a refund less the cost of shipping and handling.  We do not charge a restocking fee.  All refunds will be made in the form of a check regardless of the original form of payment. We cannot accept returns on our videos "Building System Safeguards for the Safe Use of High-Alert Medications", "Patient Safety Requires a Team Effort", "Patients Play a Vital Role in Patient Safety", "Medical Leaders in Patient Safety", or any item that is not returned in its original condition, is damaged, or is missing parts.

CD-HYDROmorphone: Balancing the Benefit and Risk for Patient Care (11/17/10)
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