Darvocet (propoxyphene Napsylate/acetaminophen)

Clinical Medications Worksheets Generic Name propoxyphene napsylate/acetaminophen Peak 2-3 hr

Trade Name Darvocet-N

Classification opioid analgesics

Onset 15-60 min

Dose 100-200 mg

Duration 4-6 hr

Mechanism of action and indications (Why med ordered) 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 Interactions with other patient drugs, OTC or herbal medicines (ask patient specifically) Lisinopril: Many psychotherapeutic and CNS-active agents (e.g., anxiolytics, sedatives, hypnotics, antidepressants, antipsychotics, opioids, alcohol, muscle relaxants) exhibit hypotensive effects, especially during initiation of therapy and dose escalation. Coadministration with antihypertensive agents, in particular vasodilators and alpha-blockers, may result in additive effects on blood pressure and orthostasis. Lexapro, Restoril, Percocet, morphine, Reglan, Phenergan: Sedatives, tranquilizers, muscle relaxants, antidepressants, and other central nervous system (CNS) depressants may have additive CNS- and/or respiratorydepressant effects with propoxyphene. Misuse of propoxyphene, either alone or in combination with other CNS depressants, has been a major cause of drug-related deaths, particularly in patients with a history of emotional disturbances, suicidal ideation, or alcohol and drug abuse. 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

Route PO

Time/frequency q 4 hours PRN

For IV meds, compatibility with IV drips and /or solutions N/A Nursing Implications (what to focus on) Contraindications/warnings/interactions Appears on Beers list. Elderly or debilitated patients require reduced dosages Undiagnosed abdominal pain, Hypothyroidism, Common side effects dizziness, weakness, nausea 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

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