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Dezocine
Pronunciation
U.S. Brand Names
Generic Available
Pharmacological Index
Use
Pregnancy Risk Factor
Contraindications
Warnings/Precautions
Adverse Reactions
Overdosage/Toxicology
Drug Interactions
Stability
Mechanism of Action
Pharmacodynamics/Kinetics
Usual Dosage
Monitoring Parameters
Mental Health: Effects on Mental Status
Mental Health: Effects on Psychiatric Treatment
Dental Health: Local Anesthetic/Vasoconstrictor Precautions
Dental Health: Effects on Dental Treatment
Patient Information
Nursing Implications
Dosage Forms
References

Pronunciation
(DEZ oh seen)

U.S. Brand Names
Dalgan®

Generic Available

No


Pharmacological Index

Analgesic, Narcotic


Use

Relief of moderate to severe postoperative, acute renal and ureteral colic, and cancer pain


Pregnancy Risk Factor

C


Contraindications

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.


Warnings/Precautions

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


Adverse Reactions

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


Overdosage/Toxicology

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


Drug Interactions

Increased effect with CNS depressants


Stability

Store at room temperature; protect from light


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


Pharmacodynamics/Kinetics

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


Usual Dosage

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


Monitoring Parameters

Monitor blood pressure and heart rate during adjustment of dose


Mental Health: Effects on Mental Status

Sedation is common; may see depression


Mental Health: Effects on Psychiatric Treatment

Contraindicated with other CNS depressants


Dental Health: Local Anesthetic/Vasoconstrictor Precautions

No information available to require special precautions


Dental Health: Effects on Dental Treatment

No effects or complications reported


Patient Information

Avoid driving or operating machinery until the effect of drug wears off; may cause physical and psychological dependence with prolonged use


Nursing Implications

Watch closely for respiratory depression; induced respiratory depression is greater than that seen with morphine during the first hour after administration


Dosage Forms

Injection, single-dose vial: 5 mg/mL (2 mL); 10 mg/mL (2 mL); 15 mg/mL (2 mL)


References

"Drugs for Pain," Med Lett Drugs Ther, 1998, 40(1033):79-84.


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