Darvacet

NURS 2516 Clinical Medications Worksheets (You will need to make additional copies of these forms) Generic Name propoxyphene  napsylate/acetaminophen

Trade Name

Classification opioid analgesics

Dose N-100 mg

Route PO

Time/frequency q 4 hours PRN

Darvocet-N

Peak

Onset

Duration

2-3 hr

15-60 min

4-6 hr

For IV meds, compatibility with IV drips and /or solutions

Mechanism of action and indications (Why med ordered)

Nursing Implications (what to focus on) Contraindications/warnings/interactions

Mild to moderate pain Binds to opiate receptors in the CNS Alters the perception of and response to painful stimuli, while producing generalized CNS depression

Appears on Beers list. Elderly or debilitated patients require reduced dosages Undiagnosed abdominal pain, Hypothyroidism,

Common side effects dizziness, weakness, nausea

Interactions with other patient drugs, OTC or herbal medicines (ask patient specifically) ↑ CNS depression with antidepressants , and sedative/hypnotics

Lab value alterations caused by medicine May cause ↑ serum amylase and lipase levels, May cause ↑ AST, ALT, serum alkaline phosphatase, LDH, and bilirubin

Be sure to teach the patient the following about this medication Instruct patient on how and when to ask for pain medication Encourage patient to turn, cough, and breathe deeply every 2 hr to prevent atelectasis Advise patient to change positions slowly to minimize orthostatic hypotension Advise patient that good oral hygiene, frequent mouth rinses, and sugarless gum or candy may decrease dry mouth

Nursing Process- Assessment (Pre-administration assessment) Assess type, location, and intensity of pain prior to and 2 hr (peak) following administration. Assess bowel function routinely. Prevention of constipation should be instituted with increased intake of fluids and bulk, and laxatives to minimize constipating effects. Stimulant laxatives should be administered routinely if opioid use exceeds 2-3 days, unless contraindicated Geriatric patients may be more sensitive to CNS effects; monitor closely and assess falls risk

Assessment Why would you hold or not give this med? Assess blood pressure, pulse, and respirations before and periodically during administration. If respiratory rate is <10/min, assess level of sedation. Physical stimulation may be sufficient to prevent significant hypoventilation. Dose may need to be decreased by 25-50%. Initial drowsiness will diminish with continued use

Evaluation Check after giving Decrease in severity of pain without a significant alteration in level of consciousness