OXYMORPHONE HYDROCHLORIDE

OXYMORPHONE HYDROCHLORIDe
(ox-i-mor'fone)
Numorphan, Opana, Opana ER
Classifications: narcotic (opiate) agonist; analgesic;
Therapeutic: narcotic analgesic

Prototype: Morphine
Pregnancy Category: C
Controlled Substance: Schedule II

Availability

1 mg/mL, 1.5 mg/mL injection; 5 mg suppositories; 10 mg extended release tablets; 10 mg tablets

Action

Structurally and pharmacologically related to morphine. Analgesic action for moderate to severe pain. Produces mild sedation and, unlike morphine, has little antitussive action.

Therapeutic Effect

Effective in relief of moderate to severe pain.

Uses

Relief of moderate to severe pain, preoperative medication, obstetric analgesia, support of anesthesia, and relief of anxiety in patients with dyspnea associated with acute ventricular failure and pulmonary edema.

Contraindications

Pulmonary edema resulting from chemical respiratory irritants; ileus; status asthmaticus; pregnancy (category C), children <12 y.

Cautious Use

Alcoholism; biliary tract disease; bladder obstruction; severe pulmonary disease, respiratory insufficiency, COPD; depression; older adults; lactation.

Route & Dosage

Moderate to Severe Pain
Adult: PO 10–20 mg q4–6h prn; extended release 5–10 mg q12h SC/IM 1–1.5 mg q4–6h prn IV 0.5 mg q4–6h PR 5 mg q4–6h prn

Analgesia during Labor
Adult: IM 0.5–1 mg

Administration

Subcutaneous/Intramuscular
  • Give undiluted.
Intravenous

PREPARE: Direct: Dilute in 5 mL of sterile water or NS.  

ADMINISTER: Direct: Give at a rate of 0.5 mg over 2–5 min.  

  • Protect drug from light. Store suppositories in refrigerator 2°–15° C (36°–59° F).

Adverse Effects (≥1%)

GI: Nausea, vomiting, euphoria. CNS: Dizziness, lightheadedness, sedation. Respiratory: Respiratory depression (see morphine), apnea, respiratory arrest. Body as a Whole: Sweating, coma, shock. CV: Cardiac arrest, circulatory depression.

Interactions

Drug: Alcohol and other cns depressants add to CNS depression; propofol increases risk of bradycardia.

Pharmacokinetics

Onset: 5–10 min IV; 10–15 min IM; 15–30 min PR. Peak: 1–1.5 h. Duration: 3–6 h. Distribution: Crosses placenta. Metabolism: In liver. Elimination: In urine. Half-Life: PO 7–9 h; extended release 9–11 h.

Nursing Implications

Assessment & Drug Effects

  • Monitor respiratory rate. Withhold drug and notify physician if rate falls below 12 breaths per min.
  • Supervise ambulation and advise patient of possible light-headedness. Older adult and debilitated patients are most susceptible to CNS depressant effects of drug.
  • Evaluate patient's continued need for narcotic analgesic. Prolonged use can lead to dependence of morphine type.
  • Medication contains sulfite and may precipitate a hypersensitivity reaction in susceptible patient.

Patient & Family Education

  • Use caution when walking because of potential for injury from dizziness.
  • Do not consume alcohol while taking oxymorphone.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

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