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Pronunciation |
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(oks
i KOE done & a seet a MIN oh
fen) |
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U.S. Brand
Names |
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Endocet®; Percocet® 2.5/325;
Percocet® 5/325; Percocet® 7.5/500; Percocet® 10/650;
Roxicet® 5/500; Roxilox™; Tylox® |
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Generic
Available |
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Yes |
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Canadian Brand
Names |
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Endocet®; Oxycocet;
Percocet®-Demi |
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Synonyms |
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Acetaminophen and Oxycodone |
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Pharmacological Index |
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Analgesic, Narcotic |
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Use |
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Dental: Treatment of postoperative pain
Medical: Management of moderate to severe pain |
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Restrictions |
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C-II |
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Pregnancy Risk
Factor |
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C |
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Contraindications |
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Hypersensitivity to oxycodone, acetaminophen or any component; severe
respiratory depression, severe renal or liver insufficiency |
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Warnings/Precautions |
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Use with caution in patients with hypersensitivity reactions to other
phenanthrene derivative opioid agonists (morphine, codeine, hydrocodone,
hydromorphone, levorphanol, oxymorphone); respiratory diseases including asthma,
emphysema, COPD, or severe liver or renal insufficiency; some preparations
contain sulfites which may cause allergic reactions; may be habit-forming
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Adverse
Reactions |
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>10%:
Cardiovascular: Hypotension
Central nervous system: Fatigue, drowsiness, dizziness
Gastrointestinal: Nausea, vomiting
Neuromuscular & skeletal: Weakness
1% to 10%:
Central nervous system: Nervousness, headache, restlessness, malaise,
confusion
Gastrointestinal: Anorexia, stomach cramps, xerostomia, constipation, biliary
spasm
Genitourinary: Ureteral spasms, decreased urination
Local: Pain at injection site
Respiratory: Dyspnea, shortness of breath
<1%: Mental depression, hallucinations, paradoxical CNS stimulation,
increased intracranial pressure, rash, urticaria, paralytic ileus, blood
dyscrasias (neutropenia, pancytopenia, leukopenia), hepatic necrosis with
overdosage, renal injury with chronic use, physical and psychological
dependence, hypersensitivity reactions (rare), histamine release
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Drug
Interactions |
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Decreased effect: Phenothiazines may antagonize the analgesic effect of
opiate agonists
Increased toxicity: CNS depressants, tricyclic antidepressants may potentiate
the effects of opiate agonists; dextroamphetamine may enhance the analgesic
effect of opiate agonists |
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Mechanism of
Action |
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Oxycodone, as with other narcotic (opiate) analgesics, blocks pain perception
in the cerebral cortex by binding to specific receptor molecules (opiate
receptors) within the neuronal membranes of synapses. This binding results in a
decreased synaptic chemical transmission throughout the CNS thus inhibiting the
flow of pain sensations into the higher centers. Mu and kappa are the two
subtypes of the opiate receptor which oxycodone binds to cause analgesia.
Acetaminophen inhibits the synthesis of prostaglandins in the CNS and
peripherally blocks pain impulse generation; produces antipyresis from
inhibition of hypothalamic heat-regulating center |
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Pharmacodynamics/Kinetics |
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Onset of effect: Narcotic analgesia: 0.5-1 hour
Duration of effect: 4-6 hours
Serum half-life: Oxycodone: 2-3 hours |
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Usual Dosage |
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Oral (doses should be titrated to appropriate analgesic effects):
Adults: 1-2 tablets every 4-6 hours as needed for pain
Maximum daily dose of acetaminophen: 4 g/day
Dosing adjustment in hepatic impairment: Dose should be reduced in
patients with severe liver disease |
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Dietary
Considerations |
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No data reported |
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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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1% to 10% of patients experience dry mouth |
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Patient
Information |
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See individual agents. Pregnancy/breast-feeding precautions: Inform
prescriber if you are or intend to get pregnant. Consult prescriber if
breast-feeding. |
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Nursing
Implications |
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Monitor for pain relief, respiratory and mental status, blood pressure,
constipation |
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Dosage Forms |
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Caplet: Oxycodone hydrochloride 5 mg and acetaminophen 500 mg
Capsule: Oxycodone hydrochloride 5 mg and acetaminophen 500 mg
Solution, oral: Oxycodone hydrochloride 5 mg and acetaminophen 325 mg per 5
mL (5 mL, 500 mL)
Tablet: Oxycodone hydrochloride 2.5 mg and acetaminophen 325 mg; oxycodone
hydrochloride 5 mg and acetaminophen 325 mg; oxycodone hydrochloride 7.5 mg and
acetaminophen 500 mg; oxycodone hydrochloride 10 mg and acetaminophen 650 mg
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References |
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Cooper SA, Precheur H, Rauch D, et al,
"Evaluation of Oxycodone and Acetaminophen in Treatment of Postoperative Pain,"
Oral Surg Oral Med Oral Pathol, 1980, 50(6):496-501.
Dionne RA, "New Approaches to Preventing and Treating Postoperative Pain,"
J Am Dent Assoc, 1992, 123(6):26-34.
Gobetti JP, "Controlling Dental Pain," J Am Dent Assoc, 1992,
123(6):47-52.
Olkkola KT, Hamunen K, and Maunuksela EL,
"Clinical Pharmacokinetics and Pharmacodynamics of Opioid Analgesics in Infants and Children,"
Clin Pharmacokinet, 1995, 28(5):385-404.
Sinatra RS and Harrison DM, "Oxymorphone in Patient-Controlled Analgesia,"
Clin Pharm, 1989, 8(8):541, 544. |
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