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Dezocine - A Narcotic Agonist-Antagonist Analgesic

Author: Guest, Posted on Wednesday, October 08 @ 01:18:32 IST by RxPG  

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Pharmacology


Dezocine has become a contetious topic after being asked in PGI exam recently. Since it is not given in details in KDT book, I have tried to put together some reliable information here.
Dezocine
(DEZ-oh-seen)

Classification: Narcotic agonist-antagonist analgesic

Action/Kinetics: Parenteral narcotic analgesic possessing both agonist and antagonist activity. Similar to morphine with respect to analgesic potency and onset and duration of action. Less risk of abuse due to the mixed agonist-antagonist properties of the drug. The narcotic antagonist activity is greater than that of pentazocine. Onset: Approximately 30 min after IM and approximately 15 min after IV. Peak effect: 30-150 min. Peak plasma levels: 10-38 ng/mL after a 10-mg dose. Duration: 2-4 hr. t1/2, after IV: 2.4 hr. Approximately two-thirds of a dose is excreted in the urine mostly as the glucuronide conjugate.


Uses: Analgesic when use of a narcotic is desirable.


Contraindications: Lactation. Individuals dependent on narcotics. SC administration.


Special Concerns: Elderly clients are at an increased risk for altered respiratory patterns and mental changes.


Side Effects: CNS: Sedation (common), dizziness, vertigo, confusion, anxiety, crying, sleep disturbances, delusions, headache, depression, delirium. Respiratory: Respiratory depression, atelectasis. CV: Hypotension, irregular heart or pulse, hypertension, chest pain, pallor, thrombophlebitis. GI: N&V, dry mouth, constipation, abdominal pain, diarrhea. Dermatologic: Reactions at the injection site, pruritus, rash, erythema. EENT: Diplopia, blurred vision, congestion in ears, tinnitus. GU: Urinary frequency, retention, or hesitancy. Miscellaneous: Sweating, chills, edema, flushing, low hemoglobin, muscle cramps or aches, muscle pain, slurred speech.


Overdose Management: Treatment: Naloxone IV with appropriate supportive measures including oxygen, IV fluids, vasopressors, and artificial respiration.


Drug Interactions: Additive depressant effect when used with general anesthetics, sedatives, antianxiety drugs, hypnotics, alcohol, and other opiate analgesics.


How Supplied: Injection: 5 mg/mL, 10 mg/mL, 15 mg/mL


Dosage
•IM Analgesia.
Adults: 5-20 mg (usual is 10 mg) as a single dose; dose may be repeated q 3-6 hr with dosage adjusted, if necessary, depending on the status of the client.
•IV Analgesia.
Adults: 2.5-10 mg (usual initial dose is 5 mg) repeated q 2-4 hr.





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