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DRUG STUDY

GENERIC NAME: oxycodone TRADE NAME: Oxycontin CLASSIFICATION: opiod analgesic ACTION: Bind to opiate receptors in the CNS. Alter the perception of and response to painful stimuli, while producing generalized CNS depression. Therapeutic Eeffects: Decreased pain. PARMACOKENETICS Absorption: Well absorbed from GI tract. Distribution: Widely distributed. Enters breast milk Metabolism and Excretion: Mostly metabolized by the liver Half-life: Oxycontin - 4.5 hrs. CONTRINDICATION/PRECAUTIONS Contrindicated in: Hypersensitivity. Some products contain alcohol or bisulfites and should be avoided with known intolerance. Use Cautiously in : Head trauma, severe renal, hepatic or pulmonary disease. Hypothroidism, alcoholism, geriatric or debilitated patients. Undiagnosed abdominal pain. ADVERSE REACTIONS/SIDE EFFECTS CNS: confusion,sedation, dizziness, dysphoria, euphria, floating feeling, hallucinations, headache, unusual dreams. EENT: blurred vision, diplopia, miosis. RESP: Respiratory depression. CV: orthostatic hypotension. GI: constipapion, dry mouth, nausea, vomiting. GU: urinary retention Derm: flushing, sweating. Misc: physical dependence, psychological dependence, tolerance. INTERACTIONS Drug-drug: Use with caution in patients receiving MAO inhibitors (may result in unpredictable reactions). Increased CNS depression with alcohol, antihistamines, and sedative/hypnotics. Nalbuphine, bupreorphine or pentazoine may decrease anagesia. Drug-Natural Products: Continual use of kava, valerian or chamomile can increase CNS depression.

ROUTE/DOSAGE PO: Oxycontin (controlled-release tablets) q 12 hr after carefully consideration of dose.

NURSING IMPLICATIONS OF DRUG ADMINISTRATION Assessment •Obtain complete health history, including allergies, pulmonary, cardiac, renal, biliary and mental or sleep disorder, including EKG and laboratory studies: CBC, BUN, creatinine, electrolytes, liver function tests. •Obtain patient's drug history to determine possible drug interactions and allergies •Assess respiratory function. •Assess LOC and pain •Prolong use may lead to physical and psychological dependence and tolerance. Progressively higher doses may be required to relieve pain in long term theraphy. •Assess bowel function routinely. Patient should increase fluids.

•Toxicity and Overdose: Narcan is the antidote if overdose occurs
Potential Nursing Diagnoses •Acute Pain •Ineffictive Breathing Pattern, related to sedation effect of drug •Constipation, related to drug action •Deficient Knowledge, related to drug action and side effects. Planning •Patient will repaor pain relief or reduction in pain. •Patient will demonstrate understanding of the drugs action by describing side effects and precautions

•Patient will immediately report effects such as retlesness, anxiety, depression, hallucination, nasea or itching. •Patient will maintain bowel fuction within normal pattern. •Patient will maintain a respiratory rate at least 15 beats per minute. Implementation

•High ALert: Accidental overdosage of opioid analgesics has resulted in
fatalities. Check orders. Do Not confuse oxycodone with Oxcontin. •Regularly administer doses may be more effective than prn. •Co- administration with nonopioid analgesics may have additive effect and permit lower doses. •Medication should be discontinued over a longer period of time to prevent withdrawal symtoms. •PO: may be taken with food or milk to lessen GI irritation. •Controlled release tablets (Oxcontin) should be swallowed whole; do not crush or break as this would lead to rapid release and absorption of a potentially fatal dose of oxycodone). •Controlled release tablets (Oxcontin) dose should be based on 24 hr time table, with short acting opiods for breakthough pain. Patient Teaching •Instruct patient on how and when to ask for pain medication. Caution patient not to increase the dose of controlled-release oxycodone (Oxcontin) without consulting health care professionals. •Caution Patient that controlled-release oxycodone (Oxcontin) is a potenial drug for abuse. This drug should be protected from theft and never given to anyone other than whom it has been prescribed for. •Medication may cause drowsiness or dizziness and avoid ativities that require alertness. •Advise patient to avoid alcohol or other CNS depressants. •Advise patient to make positional changes slowly to avoid orthostatic hypotension. •Advise patient to increase fluids and dietary fiber to avoid constipation. May need laxatives. •Encourage patient to turn and cough and breath deeply every 2hrs.to prevent atelectasis.

Evaluation •Decrease in severity of pain without a significant alteration in level of consciousness or respiratory status.