Details About Generic Salt ::  Propoxyp

Main Medicine Class:: Narcotic analgesic   

(pro-POX-ee-feen)

Propoxyphene Hydrochloride

Darvon-N, Darvon Pulvules

Class: Narcotic analgesic

 

Action Relieves pain by stimulating opiate receptors in CNS; also causes respiratory depression, peripheral vasodilation, inhibition of intestinal peristalsis, sphincter of Oddi spasm, stimulation of chemoreceptors that cause vomiting and increased bladder tone.

 

Indications Relief of mild-to-moderate pain.

 

Contraindications Upper airway obstruction; acute asthma; diarrhea caused by poisoning or toxins.

 

Route/Dosage

PROPOXYPHENE HYDROCHLORIDE

ADULTS: PO 65 mg q 4 hr prn; not to exceed 390 mg/day.

PROPOXYPHENE NAPSYLATE

ADULTS: PO 100 mg q 4 hr prn; not to exceed 600 mg/day.

 

Interactions

Carbamazepine: Increased carbamazepine serum concentrations. Charcoal: Charcoal decreases the GI absorption of propoxyphene. Cigarette smoking: Decreased propoxyphene effect caused by liver enzyme induction. CNS depressants (eg, alcohol, barbiturate anesthetics, sedatives, tranquilizers): Additive CNS depression. Protease inhibitors: Avoid combination with propoxyphene. Warfarin: Potentiation of hypoprothrombinemic effect.

 

Lab Test Interferences Increased amylase and lipase for up to 24 hr after administration.

 

Adverse Reactions

CV: Hypotension. CNS: Lightheadedness; dizziness; sedation; disorientation; incoordination; paradoxical excitement; hallucinations; euphoria; dysphoria; insomnia. DERM: Sweating; pruritus; urticaria. GI: Nausea; vomiting; constipation; abdominal pain. GU: Urinary retention or hesitancy. HEPA: Jaundice; abnormal liver function tests. RESP: Depression of cough reflex. OTHER: Tolerance; psychological and physical dependence with chronic use; weakness.

 

Precautions

Pregnancy: Category C. Category D-if used for long periods. Lactation: Excreted in breast milk. Children: Not recommended for children. Elderly: The rate of propoxyphene metabolism may be reduced in some patients. Consider increased dosing interval. Special risk patients: Use with caution in patients with myxedema, acute alcoholism, acute abdominal conditions, ulcerative colitis, decreased respiratory reserve, head injury or increased intracranial pressure, hypoxia, supraventricular tachycardia, depleted blood volume or circulatory shock. Drug dependence: Has abuse potential. Fatalities: Excessive doses of propoxyphene alone or with other CNS depressants (including alcohol) are major cause of drug-induced death. Do not use in patients who are suicidal or addiction prone. Hepatic or renal impairment: Duration of action may be prolonged; may need to reduce dose.

PATIENT CARE CONSIDERATIONS

 

Administration/Storage

• Administer with food if GI upset occurs.
• Be aware that 65 mg of HCl form is equivalent to 100 mg of napsylate form in delivering same amount of propoxyphene.
• Store in light-resistant container at room temperature.

 

Assessment/Interventions

• Obtain patient history, including drug history and any known allergies. Note potential for suicide or drug dependence.
• Assess pain prior to and 30 to 60 min after administration.
• Provide safety measures (eg, accessible call bell, side rails, night light) and assist with ambulation.
• Monitor for prolonged duration of action in cases of hepatic or renal impairment and report to physician; dose may need to be reduced.
• Observe for respiratory depression, dizziness, sedation, nausea, vomiting, or constipation; notify physician if these symptoms occur.

OVERDOSAGE: SIGNS & SYMPTOMS   CNS depression (stupor to coma), respiratory depression, hypotension, seizures, pulmonary edema, cardiac arrhythmias, respiratory-metabolic acidosis

 

Patient/Family Education

• Advise patient to take drug with food if GI upset occurs.
• Explain that increasing fluid and fiber intake may help decrease constipation. Use of stool softeners and laxatives may also be suggested.
• Advise patient not to wait until pain level is high to self-medicate because drug will not be as effective.
• For long-term therapy, explain that dosage will be tapered gradually to prevent withdrawal symptoms.
• Tell patient to notify physician if drug does not provide pain relief.
• Instruct patient to report the following symptoms to physician: Shortness of breath or difficulty breathing, nausea, vomiting, constipation or other effects of drug.
• Caution patient to avoid sudden position changes to prevent orthostatic hypotension.
• Instruct patient to avoid intake of alcoholic beverages or other CNS depressants.
• Advise patient that drug may cause drowsiness or dizziness and to use caution while driving or performing other tasks requiring mental alertness.

Drugs Class ::

Action Relieves pain by stimulating opiate receptors in CNS; also causes respiratory depression, peripheral vasodilation, inhibition of intestinal peristalsis, sphincter of Oddi spasm, stimulation of chemoreceptors that cause vomiting and increased bladder tone.