Details About Generic Salt ::  Butalbi3

Main Medicine Class:: Narcotic analgesic   

(BYOO-TAL-bih-tuhl/ASS-pihr-in/Kaff-EEN/KOE-deen FOSS-fate)
Fiorinal with Codeine,  Fiorinal-C
Class: Narcotic analgesic

 

Drugs Class ::

 Action Butalbital has generalized depressant effect on CNS and, in very high doses, has peripheral effects. Aspirin has analgesic, antipyretic, anti-inflammatory and antirheumatic effects; its analgesic and anti-inflammatory effects may be mediated through inhibition of prostaglandin synthetase enzyme complex. Aspirin also irreversibly inhibits platelet aggregation. Caffeine is thought to produce constriction of cerebral blood vessels. Codeine binds to opiate receptors in 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 salicylates, aspirin, caffeine, opiates or barbiturates; porphyria; bleeding disorders; syndrome of nasal polyps, angioedema and bronchospastic reactivity to aspirin or other NSAIDs; peptic ulcer.

Drug Precautions ::

 Precautions

Pregnancy: Category C. Lactation: Undetermined. Children: Safety and efficacy in children < 12 yr not established. Drug dependency: Prolonged use may produce drug tolerance and dependency (psychologic and physical). Head injury: Respiratory depressant effects may be enhanced and CSF pressure may be increased. Peptic ulcer, coagulation abnormalities and preoperative states: Use extreme caution because of increased bleeding time. Renal or hepatic impairment: Use caution because of decreased elimination. Reye’s syndrome: May occur in children due to aspirin component; do not use for chickenpox or flu symptoms.

PATIENT CARE CONSIDERATIONS


Drug Side Effects ::

 Adverse Reactions

CV: Tachycardia. CNS: Drowsiness; dizziness; lightheadedness; confusion; mental depression; unusual excitement; nervousness. DERM: Rash; pruritus. GI: Nausea; vomiting; flatulence; heartburn; abdominal pain; constipation.

Drug Mode of Action ::  

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

Drug Interactions ::

 Interactions

Beta-blockers (eg, propranolol), doxycycline, estrogens (including oral contraceptives), felodipine, griseofulvin, nifedipine, phenylbutazone, quinidine, theophylline: Effects of these drugs may be decreased. Corticosteroids: May enhance renal clearance of aspirin; sudden discontinuation of corticosteroids may result in symptoms of salicylism; effects of corticosteroid may be decreased. Insulin, oral antidiabetic agents: Hypoglycemic effects may be increased. MAO inhibitors: May increase CNS effects. Methotrexate, 6-mercaptopurine: Bone marrow toxicity may occur. NSAIDs: Increased GI ulceration may occur. Other CNS depressants (ethanol, narcotics, general anesthetics, tranquilizers, sedative-hypnotics): Increased drowsiness, dizziness and other CNS depressive effects may occur. Probenecid, sulfinpyrazone: Uricosuric effects may be decreased. Tricyclic antidepressants: Antidepressant effects may decrease. Warfarin: Anticoagulant effects may be increased or decreased.

Drug Assesment ::

 Assessment/Interventions

  • Obtain patient history, including drug history and any known allergies.
  • Assess pain before administration to establish baseline.
  • Assess vital signs before administration. Withhold dose if respiratory rate < 12 bpm (< 20 bpm in children) and notify physician.
  • Assess related factors that may precipitate or worsen pain such as anxiety, fear, or stress.
  • Assess cough for productiveness and effectiveness. Auscultate for rales.
  • Administer scheduled dose before pain is severe.
  • 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 of any significant change.
  • Assess for dizziness, sedation, or euphoria. Institute safety precautions as needed.
  • Assess for urinary retention or constipation.
  • Use adjunct pain relief measures (eg, massage, positioning, maintaining quiet environment and emotional support) to enhance effectiveness.
  • Provide high-fiber diet with 2 to 3 L of fluid 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
  Hyperthermia, tachycardia, respiratory depression, bleeding, drowsiness, confusion, coma, hypotension, hypovolemic shock, nausea, vomiting, tremor, fluid and electrolyte abnormalities, insomnia, restlessness

Drug Storage/Management ::

 Administration/Storage

  • Give with food or water.
  • Discard if strong vinegar-like odor is present.
  • 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.
  • Tell patient to take with food or full glass of water.
  • Instruct patient not to discontinue abruptly after long-term regular use.
  • Caution patient to avoid intake of alcoholic beverages and other CNS depressants.
  • Warn patient to avoid any hazardous activity (eg, driving, operating heavy machinery) if dizziness, drowsiness or a decrease in mental acuity occurs.
  • Instruct patient to avoid sudden position changes to prevent orthostatic hypotension.
  • Tell patient to notify physician if any surgical procedures are required. Aspirin therapy should be discontinued 5 days before surgery to reduce potential for bleeding problems.
  • Instruct patient not to take otc medications without consulting physician.
  • Advise patient to report the following symptoms to physician: Persistent or recurring pain before next scheduled dose, difficulty breathing, blurred vision, buzzing in ears, increased drowsiness, vomiting, abdominal pain, tarry stools, unusual bruising or bleeding.

Disclaimer ::

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