Which routes are appropriate for hydromorphone administration?

Which routes are appropriate for hydromorphone administration?

• A. Intrathecal, intranasal, inhalational, IV.
• B. Oral, topical, buccal, IV.
• C. Subcutaneous, IM, inhalational, IV.
• D. PO, IV, epidural, intrathecal.

Answer: (D)

Hydromorphone can be given through several routes, but the clinically appropriate options include oral (po), intravenous (IV), and neuraxial administration (epidural or intrathecal). The oral route allows systemic analgesia with the usual pharmacokinetics of an oral opioid, while IV provides rapid onset for acute pain relief. Neuraxial delivery—epidural or intrathecal—offers potent analgesia with targeted effects in the spinal canal, which is particularly useful during and after surgery, though it carries risks that require careful monitoring. Routes like inhalational or intranasal are not standard for hydromorphone in typical anesthesia practice, and topical or buccal routes are not routinely used for this opioid. Thus, the combination of oral, IV, epidural, and intrathecal administration represents the appropriate routes.

Hydromorphone can be given through several routes, but the clinically appropriate options include oral (po), intravenous (IV), and neuraxial administration (epidural or intrathecal). The oral route allows systemic analgesia with the usual pharmacokinetics of an oral opioid, while IV provides rapid onset for acute pain relief. Neuraxial delivery—epidural or intrathecal—offers potent analgesia with targeted effects in the spinal canal, which is particularly useful during and after surgery, though it carries risks that require careful monitoring. Routes like inhalational or intranasal are not standard for hydromorphone in typical anesthesia practice, and topical or buccal routes are not routinely used for this opioid. Thus, the combination of oral, IV, epidural, and intrathecal administration represents the appropriate routes.