The acute form of hepatitis, generally caused by viral infection, is characterized by constitutional symptoms that are typically self-limiting. Chronic hepatitis presents similarly, but can manifest signs and symptoms specific to liver dysfunction with long-standing inflammation and damage to the organ.
1 Hydromorphone is a minor metabolite of morphine and may be excreted in urine at concentrations up to 2.5% of the morphine concentration. 2  Consequently, the detection of minor amounts of hydromorphone in urine containing high concentrations of codeine should not be interpreted as evidence of hydromorphone use.
Upon discharge a narcotic, hydromorphone 2 mg bid PRN, was started. Hydromorphone, like morphine and oxymorphone, is metabolized primarily by through glucuronidation by uridine diphosphate glucuronosyl transferase enzymes in the liver rather than the cytochrome p450 system and, therefore, does not interact with diltiazem .