OXYCODONE HYDROCHLORIDE (ox-i-koe'done)
OxyContin, Percolone, Endocodone, OxyFAST, Roxicodone Classifications: narcotic (opiate) agonist; analgesic; Therapeutic: narcotic analgesic Prototype: Morphine Pregnancy Category: B (D for prolonged use or use of high doses at term) Controlled Substance: Schedule II
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Availability
5 mg, 15 mg, 30 mg tablets
OxyContin: 10 mg, 20 mg, 40 mg, 80 mg, 160 mg sustained release tablets; 5 mg/5 mL, 20 mg/mL oral solution
Action
Semisynthetic derivative of an opium alkaloid with actions qualitatively similar to those of morphine. Binds with stereo-specific
receptors in various sites of CNS to alter both perception of pain and emotional response to pain, but precise mechanism
of action not clear.
Therapeutic Effect
Active against moderate to moderately severe pain. Appears to be more effective in relief of acute than long-standing pain.
Uses
Relief of moderate to moderately severe pain such as may occur with bursitis, dislocations, simple fractures and other injuries,
and neuralgia. Relieves postoperative, postextractional, postpartum pain.
Contraindications
Hypersensitivity to oxycodone and principal drugs with which it is combined; bronchial asthma; pregnancy (category B); for
prolonged use or high doses at term (category D); lactation, children <6 y.
Cautious Use
Alcoholism; renal or hepatic disease; viral infections; Addison's disease; cardiac arrhythmias; chronic ulcerative colitis;
history of drug abuse or dependency; gallbladder disease, acute abdominal conditions; head injury, intracranial lesions;
hypothyroidism; prostatic hypertrophy; respiratory disease; urethral stricture; older adult or debilitated patients; peptic
ulcer or coagulation abnormalities (combination products containing aspirin).
Route & Dosage
Moderate to Severe Pain Adult: PO 510 mg q6h prn; OxyContin can be dosed q8h Child: PO 612 y, 1.25 mg q6h prn; ≥12 y, 2.5 mg q6h prn
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Administration
Oral
- Ensure that sustained release form is not chewed or crushed. It must be swallowed whole.
- Store this DANGEROUS medication in a place inaccessible to children at 15°30° C (59°86° F). Protect from light.
Adverse Effects (≥1%)
CNS: Euphoria, dysphoria, light-headedness, dizziness,
sedation. GI: Anorexia, nausea, vomiting,
constipation, jaundice,
hepatotoxicity (combinations containing acetaminophen).
Respiratory: Shortness of breath,
respiratory depression. Skin: Pruritus, skin rash.
CV: Bradycardia.
Body as a Whole: Unusual bleeding or bruising.
Urogenital: Dysuria, frequency of urination, urinary retention.
Diagnostic Test Interference
Serum amylase levels may be elevated because oxycodone causes spasm of sphincter of Oddi. Blood glucose determinations: false decrease (measured by glucose oxidase-peroxidase method). 5-HIAA determination: false positive with use of nitroisonaphthol reagent (quantitative test is unaffected).
Interactions
Drug: Alcohol and other
cns depressants add to
CNS depressant activity.
Herbal: St. John's wort may increase sedation.
Pharmacokinetics
Absorption: Readily from GI tract.
Onset: 1015 min.
Peak: 3060 min.
Duration: 45 h.
Distribution: Crosses placenta; distributed into breast milk.
Metabolism: In liver.
Elimination: Primarily in urine.
Half-Life: 35 h.
Nursing Implications
Assessment & Drug Effects
- Monitor patient's response closely, especially to sustained-release preparations.
- Consult physician if nausea continues after first few days of therapy.
- Note: Light-headedness, dizziness, sedation, or fainting appear to be more prominent in ambulatory than in nonambulatory patients
and may be alleviated if patient lies down.
- Evaluate patient's continued need for oxycodone preparations. Psychic and physical dependence and tolerance may develop
with repeated use. The potential for drug abuse is high.
- Lab tests: Check hepatic function and hematologic status periodically in patients on high dosage.
- Be aware that serious overdosage of any oxycodone preparation presents problems associated with a narcotic overdose (respiratory
depression, circulatory collapse, extreme somnolence progressing to stupor or coma).
Patient & Family Education
- Do not alter dosage regimen by increasing, decreasing, or shortening intervals between doses. Habit formation and liver
damage may result.
- Avoid potentially hazardous activities such as driving a car or operating machinery while using oxycodone preparation.
- Do not drink large amounts of alcoholic beverages while using oxycodone preparations; risk of liver damage is increased.
- Check with physician before taking OTC drugs for colds, stomach distress, allergies, insomnia, or pain.
- Inform surgeon or dentist that you are taking an oxycodone preparation before any surgical procedure is undertaken.