| PENTAZOCINE HYDROCHLORIDe
Classifications: narcotic (opiate) agonist-antagonist; analgesic; Therapeutic: narcotic; analgesic
Pregnancy Category: C
Controlled Substance: Schedule IV
30 mg/mL injection
Synthetic analgesic with analgesic potency approximately one-third that of morphine. Opiates exert their analgesic effects
by stimulating specific opiate receptors that produce analgesia, respiratory depression, and euphoria as well as physical
Effective for moderate to severe pain relief. Acts as weak narcotic antagonist and has sedative properties.
Relief of moderate to severe pain; also used for preoperative analgesia or sedation, and as supplement to surgical anesthesia.
Hypersensitivity to sulfite; head injury, increased intracranial pressure; seizures; emotionally unstable patients, or history
of drug abuse; pregnancy (other than labor) (category C), lactation. Safe use in children <12 y is not established.
Impaired kidney or liver function; cardiac disease; COPD, asthmas, respiratory depression; GI obstruction; biliary surgery;
patients with MI who have nausea and vomiting.
Route & Dosage
|Moderate to Severe Pain (Excluding Patients in Labor)
Adult: IM/IV/SC 3060 mg q34h (max: 360 mg/d)
Child: IM 1530 mg
Women in Labor
Adult: IM 2030 mg; 20 mg may be repeated 1 or 2 times at 23 h intervals
Clcr 1050 mL/min: give 75% of dose; <10 mL/min: give 50% of dose
- IM is preferred to SC route when frequent injections over an extended period are required.
- Observe injection sites daily for signs of irritation or inflammation.
PREPARE: Direct: Give undiluted or diluted with 1 mL sterile water for injection for each 5 mg.
ADMINISTER: Direct: Give slowly at a rate of 5 mg over 60 sec.
INCOMPATIBILITIES Solution/additive: Aminophylline, barbiturates, sodium bicarbonate, glycopyrrolate, heparin, nafcillin. Y-site: Nafcillin.
Adverse Effects (≥1%)Body as a Whole:
Flushing, allergic reactions, shock. CNS: Drowsiness,
sweating, dizziness, light-headedness, euphoria,
psychotomimetic effects, confusion, anxiety, hallucinations, disturbed dreams, bizarre thoughts, euphoria and other mood
Hypertension, palpitation, tachycardia. GI: Nausea, vomiting, constipation
, dry mouth, alterations of taste. Urogenital:
Urinary retention. Respiratory: Respiratory depression. Skin:
Injection-site reactions (induration, nodule formation, sloughing, sclerosis, cutaneous depression), rash, pruritus. Special Senses:
and other cns depressants
add to CNS depression; narcotic analgesics
may precipitate narcotic withdrawal syndrome.
15 min IM, SC; 23 min IV. Peak:
1 h IM, 15 min IV. Duration:
3 h IM, 1 h IV. Distribution:
Crosses placenta. Metabolism:
Extensively in liver. Elimination:
Primarily in urine; small amount in feces. Half-Life:
Assessment & Drug Effects
- Monitor therapeutic effect. Tolerance to analgesic effect sometimes occurs. Psychologic and physical dependence have been
reported in patients with history of drug abuse, but rarely in patients without such history. Addiction liability matches
that of codeine.
- Monitor vital signs and assess for respiratory depression. Keep supine to minimize adverse efffects.
- Monitor drug-induced CNS depression.
- Be aware that pentazocine may produce acute withdrawal symptoms in some patients who have been receiving opioids on a regular
- Monitor I&O as drug may cause urinary retention.
Patient & Family Education
- Avoid driving and other potentially hazardous activities until response to drug is known.
- Do not discontinue drug abruptly following extended use; may result in chills, abdominal and muscle cramps, yawning, runny
nose, tearing, itching, restlessness, anxiety, drug-seeking behavior.