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Pronunciation |
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(DEZ
oh
seen) |
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U.S. Brand
Names |
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Dalgan® |
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Generic
Available |
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No |
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Pharmacological Index |
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Analgesic, Narcotic |
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Use |
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Relief of moderate to severe postoperative, acute renal and ureteral colic,
and cancer pain |
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Pregnancy Risk
Factor |
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C |
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Contraindications |
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Patients experiencing immediate type hypersensitivity reactions (anaphylaxis)
to dezocine or structurally related compounds should not receive this drug. Use
of other central nervous system depressants concurrently to dezocine is
contraindicated. |
|
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Warnings/Precautions |
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Use with caution in patients with head injuries or increased intracranial
pressure, respiratory depression, asthma, emphysema, COPD, renal or hepatic
disease, labor and delivery, biliary surgery, or in patients with a history of
drug abuse; abuse potential is apparent; may be better tolerated than other
opioid agonist-antagonist; does not affect cardiac performance; contains
bisulfites, avoid use in those sensitive to bisulfites |
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Adverse
Reactions |
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1% to 10%:
Central nervous system: Sedation, dizziness, vertigo
Gastrointestinal: Nausea, vomiting
Local: Injection site reactions
<1%: Hypotension, palpitations, bradycardia, peripheral vasodilation,
increased intracranial pressure, CNS depression, drowsiness, antidiuretic
hormone release, constipation, biliary tract spasm, urinary tract spasm, miosis,
respiratory depression, histamine release, physical and psychological dependence
with prolonged use |
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Overdosage/Toxicology |
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Symptoms of overdose include CNS and respiratory depression, gastrointestinal
cramping, constipation
Naloxone 2 mg I.V. (0.01 mg/kg for children) with repeat administration as
necessary up to a total of 10 mg |
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Drug
Interactions |
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Increased effect with CNS depressants |
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Stability |
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Store at room temperature; protect from light |
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Mechanism of
Action |
|
Binds to opiate receptors in the CNS, causing inhibition of ascending pain
pathways, altering the perception of and response to pain; produces generalized
CNS depression; it is a mixed agonist-antagonist that appears to bind
selectively to CNS m and D
opiate
receptors |
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|
Pharmacodynamics/Kinetics |
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Onset of analgesia: Within 15-30 minutes
Peak effect: 1 hour
Duration of analgesia: 4-6 hours
Half-life: 2.6-2.8 hours
Metabolism: Glucuronidated in liver
Elimination: Excretion of inactive metabolites and unchanged drug in the
urine |
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Usual Dosage |
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Adults (not recommended for patients <18 years):
I.V.: Initial: 2.5-10 mg; may be repeated every 2-4 hours as needed
Dosing adjustment in renal impairment: Should be used cautiously at
reduced doses |
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Monitoring
Parameters |
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Monitor blood pressure and heart rate during adjustment of
dose |
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Mental Health: Effects
on Mental Status |
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Sedation is common; may see depression |
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Mental Health:
Effects on Psychiatric
Treatment |
|
Contraindicated with other CNS depressants |
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Dental Health: Local
Anesthetic/Vasoconstrictor
Precautions |
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No information available to require special precautions |
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Dental Health:
Effects on Dental Treatment |
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No effects or complications reported |
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Patient
Information |
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Avoid driving or operating machinery until the effect of drug wears off; may
cause physical and psychological dependence with prolonged
use |
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Nursing
Implications |
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Watch closely for respiratory depression; induced respiratory depression is
greater than that seen with morphine during the first hour after
administration |
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Dosage Forms |
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Injection, single-dose vial: 5 mg/mL (2 mL); 10 mg/mL (2 mL); 15 mg/mL (2
mL) |
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References |
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"Drugs for Pain," Med Lett Drugs Ther, 1998, 40(1033):79-84.
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