1
Q
Therapeutic Classification
A
Analgesic
2
Q
Pharmacologic Classification
A
Centrally acting nonopiod analgesic
3
Q
Mechanism of Action
A
- Drug and one of metabolites bind to mu receptor
o Causes weak opioid agonist activity - Inhibits NE and serotonin reuptake in spinal neurons
o Inhibits transmission of pain impulses
4
Q
Indications
A
-Moderate pain
-Off-label uses:
o Neuropathic pain
o Restless leg syndrome
5
Q
Contraindications
A
- Hypersensitivity
- History of depression or suicidal ideation
- Pregnancy
6
Q
Precautions
A
- Codeine allergies
- History of drug abuse
- COPD
- Renal/hepatic impairment
- Increased ICP
- History of seizures
7
Q
pregnancy category?
A
Pregnancy Category C
8
Q
Drug interaction with certain antidepressants (o Carbamazepine, MAOIs)?
A
Increased risk of seizure.
9
Q
Drug interaction with alcohol?
A
Sudden death.
10
Q
Drug interaction with inhibitors of CYP2D6 enzyme?
A
Decreased analgesic effect.
11
Q
Adverse Effects
A
- Vertigo
- Dizziness
- Headache
- Nausea
- Vomiting
- Constipation
- Lethargy
- CNS stimulation effects
- Seizures
- Respiratory depression
- Physical dependence possible
12
Q
Nursing Considerations
A
- Full assessment, including pain scale
- History of substance abuse
- Bowel function
- Effectiveness of drug
- Adverse effects
Unit II Nursing 160
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