Pentazocine Talwin Relief of moderate to severe pain preferred drug for

Narcotic Agonists–Antagonists (cont.) • Pentazocine ( Talwin ) – Relief of moderate to severe pain, preferred drug for patients switched from parenteral to oral forms after surgery or labor

Copyright © 2017 Wolters Kluwer • All Rights Reserved Narcotic Agonists–Antagonists (cont.) Narcotic Agonists–Antagonists (cont.) • Actions – Act at a specific opioid receptor sites in the CNS to produce analgesia, sedation, euphoria, and hallucinations • Indications – Moderate to severe pain – Adjunct to general anesthesia – Relief of pain during labor and delivery

Copyright © 2017 Wolters Kluwer • All Rights Reserved Narcotic Agonists–Antagonists (cont.) Narcotic Agonists–Antagonists (cont.) • Pharmacokinetics – Readily absorbed IM and reach peak levels rapidly when given IV – Metabolized in the liver excreted in urine or feces – Cross placenta • Contraindications – Known allergy – Pregnancy and lactation

Copyright © 2017 Wolters Kluwer • All Rights Reserved Narcotic Agonists–Antagonists (cont.) Narcotic Agonists–Antagonists (cont.) • Cautions – Avoid using with patients with physical dependence on a narcotic – COPD and disease of the respiratory tract – Acute MI or documented CAD – Renal/Lever dysfunction • Adverse Reactions – Respiratory depression – Nausea, vomiting, constipation, and biliary spasm – Dizziness, psychosis, anxiety, hallucination – Dependency < Narcotics

Copyright © 2017 Wolters Kluwer • All Rights Reserved Narcotic Agonists–Antagonists (cont.) Narcotic Agonists–Antagonists (cont.) • Adverse Reactions – Headache – Dizziness – Psychoses – Anxiety – Hallucinations – Ureteral spasm, urinary retention

Copyright © 2017 Wolters Kluwer • All Rights Reserved Drug to Drug Interactions Drug to Drug Interactions • Anesthetics and barbiturates -> Increase respiratory depression, hypotension, and sedation • Pentazocine (Talwin) + tripelennamine (T’s and blues) combination abused for hallucinogenic and euphoric effect can be fatal complications.

Copyright © 2017 Wolters Kluwer • All Rights Reserved Nursing Considerations for Narcotics Agonists-Antagonists Nursing Considerations for Narcotics Agonists-Antagonists • Assess Pre-Administration: – History- Respiratory dysfunction, CVD, PG/Breast feeding, renal/liver dysfunction – Physical Exam- VS, Pain for baseline status, CNS orientation, affect, reflexes, respiratory status, lung sounds, bowel sounds, urinary output – Known allergy – Lab- liver/renal function, ECG tests

Copyright © 2017 Wolters Kluwer • All Rights Reserved Nursing Considerations Cont. Nursing Considerations Cont. • Post Administration Care – Assess-Pain status, VS, LOC, skin, lung sounds & respiratory status, BP, HR – Labs-LF, Kidney – Safety- Comfort measures (heat, positioning etc.), safety measures, assist with ambulation, initiate bowel program – Patient teaching-AE, No alcohol, avoid driving, getting assistance with ambulation, risk for physical dependency, need for periodic monitoring & evaluation – Things to remember- Use additional measures to relieve pain, administer small frequent meals to relieve GI upset, • Discontinuing & Overdose/Toxicity-