Abdominal Pain in Elderly Persons Medication

Updated: Jul 17, 2018
  • Author: E David Bryan, MD; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Medication

Medication Summary

The goals of pharmacotherapy are to reduce morbidity and prevent complications.

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Antispasmodics

Class Summary

Believed to work centrally by suppressing conduction in the vestibular cerebellar pathways. They may have an inhibitory effect on the parasympathetic nervous system.

Dicyclomine (Bentyl)

Smooth muscle relaxant. Fairly effective in relieving pain from biliary tract disease. May be administered PO/IM. Cannot be administered IV.

Glycopyrrolate (Robinul)

Acts in smooth muscle, the CNS, and secretory glands where it blocks action of acetylcholine at parasympathetic sites. Similar to dicyclomine in effects. May be administered IV.

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Opioid Analgesics

Class Summary

Pain control is essential to quality patient care. Analgesics ensure patient comfort, promote pulmonary toilet, and have sedating properties, which are beneficial for patients who have sustained trauma or have sustained injuries.

Morphine sulfate (Duramorph, Astramorph, MS Contin)

Generally safe in low-to-moderate doses in abdominal pain. Not recommended for biliary tract disease because of potential for sphincter of Oddi spasm.

Meperidine (Demerol)

Generally safe in low-to-moderate doses in abdominal pain. Causes less sphincter of Oddi spasm than morphine but has potential to cause CNS adverse effects.

Fentanyl citrate (Sublimaze)

Potent narcotic analgesic with much shorter half-life than morphine sulfate. Potential advantages in management of abdominal pain include short duration of action and lack of histamine release. Potential disadvantage is potential for sphincter of Oddi spasm.

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