WGU D441 PHARMACOLOGY MEDCARDS LATEST
UPDATED
Drug Class: Opioid Analgesics
5. Drug Name: oxycodone
a. Indication
i. Moderate to severe pain.
ii. Pain severe enough to require daily, around-the-clock long-term
opioid treatment and for which alternative treatment options are
inadequate (extended-release)
b. Dosage & Route
i. PO (Adults) ≥50 kg) Opioid-naive patients–5–10 mg q 3–4 hr initially, as needed
ii. PO (Adults) <50 kg) Opioid-naive patients–0.2 mg/kg q 3–4 hr initially, as needed
iii. PO (Children ≥11 yr) 0.05–0.15 mg/kg q 4–6 hr as needed, as immediate-
release product.
iv. Rectal: (Adults) 10–40 mg 3–4 times daily initially, as needed.
v. Hepatic Impairment- PO (Adults) decrease initial dose by 50–66%.
c. Adverse Effects
i. CNS: confusion, sedation, dizziness, dysphoria, euphoria, floating
feeling, hallucinations, headache, unusual dreams
ii. EENT: blurred vision, diplopia, miosis
iii. Resp: RESPIRATORY DEPRESSION (LIFE THREATENING)
iv. CV: orthostatic hypotension
v. Endo: adrenal insufficiency
vi. GI: constipation, dry mouth, choking, GI obstruction, nausea, vomiting
vii. GU: urinary retention
viii. Derm: flushing, sweating
ix. Misc: physical dependence, psychological dependence, tolerance
d. Contraindications
i. Contraindicated in: Hypersensitivity; Some products contain alcohol or
bisulfites and should be avoided in patients with known intolerance or
hypersensitivity; Significant respiratory depression; Paralytic ileus; Acute or
severe bronchial asthma; Acute, mild, intermittent, or postoperative pain
(extended-release).
ii. Use Cautiously in: Head trauma; increased intracranial pressure; Severe renal
or hepatic disease; Hypothyroidism; Adrenal insufficiency; Alcoholism; Seizure
disorders; Undiagnosed abdominal pain; Prostatic hyperplasia; Difficulty
swallowing or GI disorders that may predispose patient to obstruction;
iii. OB: Lactation: Avoid chronic use; prolonged use of opioids during pregnancy
can result in neonatal opioid withdrawal syndrome;
iv. Geri: Elderly or debilitated patients ( due to increased risk of
respiratory depression; initial dose decreased recommended);
v. Pedi: Children <11 yr (safety and effectiveness of extended-release products
not established).
e. Nursing Interventions
, i. Assess type, location, and intensity of pain prior to and 1 hr (peak) after
administration. When titrating opioid doses, increases of 25–50% should be
administered until there is either a 50% reduction in the patient's pain rating
ona numerical or visual analog scale or the patient reports satisfactory pain
relief. A repeat dose can be safely administered at the time of the peak if
previous dose is ineffective and side effects are minimal.
ii. Assess BP, pulse, and respirations before and periodically during
administration. If respiratory rate is <10/min, assess level of sedation. Physical
stimulation may be sufficient to prevent significant hypoventilation. Dose may
need to be decreased by 25–50%. Initial drowsiness will diminish with
continued use.
iii. Assess bowel function routinely. Prevention of constipation should be
instituted with increased intake of fluids and bulk, and laxatives to minimize
constipating effects. Stimulant laxatives should be administered routinely if
opioid use exceeds 2–3 days, unless contraindicated.
iv. Assess risk for opioid addiction, abuse, or misuse prior to administration. Abuse
or misuse of extended-release preparations by crushing, chewing, snorting, or
injecting dissolved product will result in uncontrolled delivery of oxycodone
and can result in overdose and death.
v. Before administering, clarify all ambiguous orders; have second
practitioner independently check original order and dose calculations.
vi. Do not confuse short-acting oxycodone with long-acting Oxycontin. Do
not confuse oxycodone with hydrocodone or oxymorphone. Do not
confuse Oxycontin with MS Contin or oxymorphone.
vii. Explain therapeutic value of medication prior to administration to enhance
the analgesic effect.
viii. PO May be administered with food or milk to minimize GI irritation.
Administer solution with properly calibrated measuring device.
ix. Take 1 tablet at a time. Swallow extended-release tablet whole; do not crush,
break, or chew. Taking broken, chewed, crushed, or dissolved extended-release
tablets may lead to rapid release and absorption of a potentially fatal dose of
oxycodone. Advise patients not to pre-soak, lick, or wet controlled-release
tablets prior to placing in the mouth. Take each tablet with enough water to
ensure complete swallowing immediately after placing in mouth. Dose should
be based on 24-hr opioid requirement determined with short-acting opioids
then converted to extended-release form.
f. Patient Teachings
i. Instruct patient on how and when to ask for and take pain medication.
ii. Advise patient that oxycodone is a drug with known abuse potential. Protect it
from theft, and never give to anyone other than the individual for whom it
was prescribed.
iii. Medication may cause drowsiness or dizziness. Advise patient to call for
assistance when ambulating or smoking. Caution patient to avoid driving
and other activities requiring alertness until response to medication is
known.
iv. Advise patients taking Oxycontin tablets that empty matrix tablets may
appear in stool.
v. Advise patient to make position changes slowly to minimize
UPDATED
Drug Class: Opioid Analgesics
5. Drug Name: oxycodone
a. Indication
i. Moderate to severe pain.
ii. Pain severe enough to require daily, around-the-clock long-term
opioid treatment and for which alternative treatment options are
inadequate (extended-release)
b. Dosage & Route
i. PO (Adults) ≥50 kg) Opioid-naive patients–5–10 mg q 3–4 hr initially, as needed
ii. PO (Adults) <50 kg) Opioid-naive patients–0.2 mg/kg q 3–4 hr initially, as needed
iii. PO (Children ≥11 yr) 0.05–0.15 mg/kg q 4–6 hr as needed, as immediate-
release product.
iv. Rectal: (Adults) 10–40 mg 3–4 times daily initially, as needed.
v. Hepatic Impairment- PO (Adults) decrease initial dose by 50–66%.
c. Adverse Effects
i. CNS: confusion, sedation, dizziness, dysphoria, euphoria, floating
feeling, hallucinations, headache, unusual dreams
ii. EENT: blurred vision, diplopia, miosis
iii. Resp: RESPIRATORY DEPRESSION (LIFE THREATENING)
iv. CV: orthostatic hypotension
v. Endo: adrenal insufficiency
vi. GI: constipation, dry mouth, choking, GI obstruction, nausea, vomiting
vii. GU: urinary retention
viii. Derm: flushing, sweating
ix. Misc: physical dependence, psychological dependence, tolerance
d. Contraindications
i. Contraindicated in: Hypersensitivity; Some products contain alcohol or
bisulfites and should be avoided in patients with known intolerance or
hypersensitivity; Significant respiratory depression; Paralytic ileus; Acute or
severe bronchial asthma; Acute, mild, intermittent, or postoperative pain
(extended-release).
ii. Use Cautiously in: Head trauma; increased intracranial pressure; Severe renal
or hepatic disease; Hypothyroidism; Adrenal insufficiency; Alcoholism; Seizure
disorders; Undiagnosed abdominal pain; Prostatic hyperplasia; Difficulty
swallowing or GI disorders that may predispose patient to obstruction;
iii. OB: Lactation: Avoid chronic use; prolonged use of opioids during pregnancy
can result in neonatal opioid withdrawal syndrome;
iv. Geri: Elderly or debilitated patients ( due to increased risk of
respiratory depression; initial dose decreased recommended);
v. Pedi: Children <11 yr (safety and effectiveness of extended-release products
not established).
e. Nursing Interventions
, i. Assess type, location, and intensity of pain prior to and 1 hr (peak) after
administration. When titrating opioid doses, increases of 25–50% should be
administered until there is either a 50% reduction in the patient's pain rating
ona numerical or visual analog scale or the patient reports satisfactory pain
relief. A repeat dose can be safely administered at the time of the peak if
previous dose is ineffective and side effects are minimal.
ii. Assess BP, pulse, and respirations before and periodically during
administration. If respiratory rate is <10/min, assess level of sedation. Physical
stimulation may be sufficient to prevent significant hypoventilation. Dose may
need to be decreased by 25–50%. Initial drowsiness will diminish with
continued use.
iii. Assess bowel function routinely. Prevention of constipation should be
instituted with increased intake of fluids and bulk, and laxatives to minimize
constipating effects. Stimulant laxatives should be administered routinely if
opioid use exceeds 2–3 days, unless contraindicated.
iv. Assess risk for opioid addiction, abuse, or misuse prior to administration. Abuse
or misuse of extended-release preparations by crushing, chewing, snorting, or
injecting dissolved product will result in uncontrolled delivery of oxycodone
and can result in overdose and death.
v. Before administering, clarify all ambiguous orders; have second
practitioner independently check original order and dose calculations.
vi. Do not confuse short-acting oxycodone with long-acting Oxycontin. Do
not confuse oxycodone with hydrocodone or oxymorphone. Do not
confuse Oxycontin with MS Contin or oxymorphone.
vii. Explain therapeutic value of medication prior to administration to enhance
the analgesic effect.
viii. PO May be administered with food or milk to minimize GI irritation.
Administer solution with properly calibrated measuring device.
ix. Take 1 tablet at a time. Swallow extended-release tablet whole; do not crush,
break, or chew. Taking broken, chewed, crushed, or dissolved extended-release
tablets may lead to rapid release and absorption of a potentially fatal dose of
oxycodone. Advise patients not to pre-soak, lick, or wet controlled-release
tablets prior to placing in the mouth. Take each tablet with enough water to
ensure complete swallowing immediately after placing in mouth. Dose should
be based on 24-hr opioid requirement determined with short-acting opioids
then converted to extended-release form.
f. Patient Teachings
i. Instruct patient on how and when to ask for and take pain medication.
ii. Advise patient that oxycodone is a drug with known abuse potential. Protect it
from theft, and never give to anyone other than the individual for whom it
was prescribed.
iii. Medication may cause drowsiness or dizziness. Advise patient to call for
assistance when ambulating or smoking. Caution patient to avoid driving
and other activities requiring alertness until response to medication is
known.
iv. Advise patients taking Oxycontin tablets that empty matrix tablets may
appear in stool.
v. Advise patient to make position changes slowly to minimize
