Classification: Analgesic, Opiates
Action: Centrally acting analgesic not chemically related to opioids but binds to mu-opioid receptors and inhibits reuptake of norepinephrine and serotonin.
Indication: Moderate to severe pain.
Adverse Reactions: Vasodilation; dizziness vertigo, headache, somnolence, stimulation, anxiety, confusion, coordination disturbances, euphoria, nervousness, Visual disturbances, dry mouth. Nausea, diarrhea, constipation, vomiting, abdominal pain, flatulence. Urinary retention.
- Assess patient’s pain before therapy and regularly thereafter to monitor drug effectiveness (give before pain become extreme)
- Assess for hypersensitivity reactions
- Monitor for possible drug induced adverse reactions
- Monitor for CNS changes
- Monitor input-output ratio and check for decreasing output which may indicate retention
- Assess changes in bowel pattern. Increase diet bulk and oral fluids and to prevent constipation
- Assess patient’s and family’s knowledge on drug therapy
- Give with antiemetic for nausea and vomiting
- Administer when pain is beginning to return; determine dosage interval by patient response
- Store in cool environment, protect from sunlight
- Instruct patient to take drug only as prescribed and not to increase dosage or interval without medical advice
- Advice patient to avoid alcohol and OTC medication without medical advice
- Warn ambulatory patients to be careful (call for assistance) when getting out of bed or walking and to refrain from performing activities that require alertness until CNS effects are known
- Instruct patient to change positions slowly to prevent orthostatic hypotension
- Instruct patient to monitor for and report occurrence of drug induced adverse reactions
- Patient is relieved of pain
- Patient does not sustain injury related to drug induced adverse reactions
- Patient and family state understanding of drug therapy