MEDICATIONS - Medicine for Mountaineering and Other Wilderness Activities - page 515

Precautions: Like other moderate to strong analgesics, Vicodin should not be given to
persons with head injuries or other disorders affecting the brain. It is habit forming when
used excessively or inappropriately.
Oxycontin and Acetaminophen
Oxycontin (OxyCodone) is an opiate that has properties similar to hydrocodone. When
combined with acetaminophen it is known as Percocet and is approximately the same
strength as Vicodin.
Precautions: Like other moderate to strong analgesics, Percocet should not be given to
persons with head injuries or other disorders affecting the brain. It is habit forming when
used excessively or inappropriately.
Morphine
Morphine is a potent analgesic that has been so widely used for so long, and so effect-
ively relieves severe pain, that it has been called “God's own medicine.” It is one of the
oldest and most valuable agents in a physician's armamentarium.
In addition to its analgesic properties, morphine has a strong sedative effect that helps
calm injured persons and limits thrashing about, which could aggravate wounds or hinder
evacuation. This sedation and morphine's euphoric effect also help relieve the anxiety that
would be expected to follow an accident.
Precautions: Morphine, like all sedatives, depresses brain function. Morphine must
never be given to a person with a central nervous system injury or disease , even a mild
disorder, because morphine would usually further impair cerebral function. After the ad-
ministration of morphine or a related drug, determining whether subsequent changes in the
person's condition are the result of progression of the disorder or the effects of the drug
would be impossible. A person who is unconscious does not require analgesia.
Since the brain controls respiration, morphine also depresses respiratory function and
must be used cautiously for persons with chest injuries or pulmonary diseases, particularly
at higher altitudes. However, relieving the pain of a severe chest injury may allow a person
to cough and breathe more deeply (in the absence of an accompanying brain disorder).
Morphine causes nausea and vomiting in some individuals. It is constipating for almost
everyone and can contribute to the development of fecal impaction.
Thisdrugmaycausespasmofthemusclescontrollingoutflowfromtheurinarybladder,
resulting in acute urinary retention, particularly following abdominal injuries.
Morphine is addicting, should be used only when specifically needed for the relief of
severe pain, and should be discontinued when less potent drugs can provide adequate anal-
gesia.
Oral administration can produce satisfactory analgesia if enough of the drug is given
(orally administered morphine is only one-third to one-sixth as effective as the injected