Darvocet

INDEX Generic Name Propoxyphene napsylate Peak 2-3 hours

Trade Name Darvocet Onset 15- 60 Min

Why is your patient taking this medication? Pain

NURS 2236 Clinical Form 3: Clinical Medications Worksheet (You will need to made additional copies of these forms) Classification Dose Route Time/Frequency opiod analgesic 100mg PO q4hr prn (1-2 tabs) 650mg PO Tylenol Duration Normal Dosage range 4-6 hours 100 mg q 4 hours 650mg q4hr (Tylenol) For IV meds, compatability with IV drips and/or solutions

Mechanism of action and indications Decrease in 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

Nursing Implications (what to focus on) Contra- Hypersensitivity Contraindications/warnings/interactions Caution- Head trauma, Increased inner crainal pressure, sever renal, hepatic or pulmonary disease, hypothyroidism, adrenal insufficiency, alcoholism, appears on Beers list, Elderly or debilitated patients require reduced dosages, undiagnosed abdominal pain prostatic hypertrophy dizziness, weakness, dysphoria, euphoria, headache, Common side effects insomnia, paradoxical excitement, sedation, blurred vision, nausea, abdominal pain, constipation, vomiting, rashes, phycial dependance, psychological dependance, tolerance

Interactions with other patient drugs, OTC, or herbal Lab value alterations caused by medicine medicines (ask patient specifically) Use Extreme caution increase serum amylase and lipase levels in patients receiving MAO inhibitors- antidepressants, increase of AST, ALT, serum alkaline phosphatase, LDH and bilirubin concentrations sedative/hypnotics, smoking, partial antagonist opiod analgesics, nalbuphine, buprenorphine,pentazocine, kava Be sure to teach the patient the following about this medication valerian, chamomile Advise patient to take medication as directed and not to take more than recommended amount. - severe permanent liver damage Instruct patient on how and when to ask for pain meds May cause drowsiness or dizziness- increased risk for falls. Don't use with alcohol Advise Patient to change positions slowly, cough, and breathe deeply every 2 hours Nursing Process - Assessment Assessment Evaluation (Pre-administration assessment Why would you hold or not give Check after giving Assess type, location and intensity of pain this med? Assess bowel function Assess blood pressure, pulso and respirations If respiration is less than 10/min Decrease in severity of pain without a before and periodically after administration Coma significant alteration in level of Assess for constipation consciousness. Assess fall risk Respirations in normal range.