Details About Generic Salt ::  Butalbi1

Main Medicine Class:: Narcotic analgesic   

(BYOO-TAL-bih-tuhl/uh-seet-uh-MIN-oh-fen/kaff-EEN/KOE-deen FOSS-fate)
Fioricet with Codeine
Class: Narcotic analgesic

 

Drugs Class ::

 Action Butalbital has generalized depressant effect on CNS and, in very high doses, has peripheral effects. Acetaminophen has analgesic and antipyretic effects; its analgesic effects may be mediated through inhibition of prostaglandin synthetase enzyme complex. Caffeine is thought to produce constriction of cerebral blood vessels. Codeine binds to opiate receptors in the CNS, causing inhibition of ascending pain pathways and altering perception of and response to pain.

Indications for Drugs ::

 Indications Relief of symptom complex of tension (or muscle contraction) headache.

Drug Dose ::

 Route/Dosage

ADULTS & CHILDREN ³ 12 YR: PO 1 to 2 tablets or capsules q 4 hr; maximum is 6 tablets or capsules/day.

Contraindication ::

 Contraindications Hypersensitivity to acetaminophen, caffeine, opiates or barbiturates; porphyria.

Drug Precautions ::

 Precautions

Pregnancy: Category C. Labor: Delivery may be prolonged and neonate may experience respiratory depression or withdrawal. Lactation: Undetermined. Children: Safety and efficacy in children < 12 years not established. Head injury: Respiratory depressant effects may be enhanced and CSF pressure may be increased. Drug dependency: Prolonged use may produce drug tolerance and dependency (psychologic and physical).

PATIENT CARE CONSIDERATIONS


Drug Side Effects ::

 Adverse Reactions

CV: Tachycardia. CNS: Drowsiness; dizziness; lightheadedness; confusion; intoxicated feeling. DERM: Rash. GI: Nausea; vomiting; flatulence; constipation. RESP: Shortness of breath.

Drug Mode of Action ::  

 Action Butalbital has generalized depressant effect on CNS and, in very high doses, has peripheral effects. Acetaminophen has analgesic and antipyretic effects; its analgesic effects may be mediated through inhibition of prostaglandin synthetase enzyme complex. Caffeine is thought to produce constriction of cerebral blood vessels. Codeine binds to opiate receptors in the CNS, causing inhibition of ascending pain pathways and altering perception of and response to pain.

Drug Interactions ::

 Interactions

Beta-blockers (eg, propranolol), corticosteroids, doxycycline, estrogens (including oral contraceptives), felodipine, griseofulvin, nifedipine, phenylbutazone, quinidine, theophylline, warfarin: Effects of these drugs may be decreased. Carbamazepine, sulfinpyrazone: May increase risk of hepatotoxicity. MAO inhibitors: May increase CNS effects. Other CNS depressants (eg, ethanol, narcotics, general anesthetics, tranquilizers, sedative-hypnotics): Increased drowsiness, dizziness and other CNS depressive effects may occur. Tricyclic antidepressants: Antidepressant effects may decrease.

Drug Assesment ::

 Assessment/Interventions

  • Obtain patient history, including drug history and any known allergies.
  • Assess pain prior to administration to establish baseline.
  • Assess related factors that may precipitate or worsen pain such as anxiety, fear, or stress.
  • Take vital signs prior to administration. Withhold dose if respiratory rate < 12 bpm (< 20 bpm in children) and notify physician.
  • Assess cough for productiveness and effectiveness. Auscultate for rales.
  • Administer scheduled dose before pain is severe.
  • Utilize adjunct pain relief measures (eg, massage, positioning, maintaining quiet environment and emotional support) to enhance effectiveness.
  • Assess therapeutic effectiveness 1 hr after dose based on patient report of relief. Do not rely on objective signs.
  • Record degree and duration of pain relief. Notify physician if product is ineffective.
  • Reassess vital signs; notify physician if there is significant change.
  • Assess for dizziness, sedation, or euphoria.
  • Assess for urinary retention or constipation.
  • Institute safety precautions if drowsiness or sedation occurs.
  • Provide high-fiber diet with 2 to 3 L of fluids unless contraindicated.
  • If constipation occurs, arrange for a stool softener or bulk laxative.
  • Encourage patient to void q 3 to 4 hr.

OVERDOSAGE: SIGNS & SYMPTOMS
  Blood dyscrasias, respiratory depression, hepatic damage, drowsiness, confusion, coma, hypotension, hypovolemic shock, nausea, tremor, vomiting, tachycardia, insomnia, restlessness

Drug Storage/Management ::

 Administration/Storage

  • Give with food or water.
  • Store in airtight, light-resistant container at room temperature.

Drug Notes ::

 Patient/Family Education

  • Caution patient that dependency/tolerance may result from long-term use.
  • Remind patient to take medication with full glass of water.
  • Instruct patient not to discontinue drug abruptly after long-term regular use.
  • Caution patient to avoid intake of alcoholic beverages and other CNS depressants without physician approval.
  • Caution patient to avoid any hazardous activity (driving or operating heavy machinery) if dizziness, drowsiness or a decrease in mental acuity occurs.
  • Warn patient that orthostatic hypotension may occur. Instruct patient to change positions slowly and to sit or lie down if symptoms occur.
  • Instruct patient not to take otc or other medications without consulting physician.
  • Warn patient that constipation could occur. Advise patient to increase dietary fiber and fluids unless contraindicated.
  • Instruct patient to report these symptoms to physician: persistent or recurrent pain occurs before next scheduled dose, difficulty breathing, blurred vision, increased drowsiness, vomiting, constipation, urinary retention or yellowing of skin or gums.

Disclaimer ::

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