Analgesics

Question 1

Mechanism of Action: Endone (Oxycodone)

Answer 1

Opioid analgesics mimic endogenous opioids by activating opioid receptors in the central and peripheral nervous systems to produce analgesia, respiratory depression, sedation and constipation.

Question 2

Indications: Endone (Oxycodone)

Answer 2

Moderate-to-severe pain

Question 3

Precautions: Endone (Oxycodone)

Answer 3

Renal: Active metabolites may increase in renal disease.

Hepatic: Avoid in sever hepatic impairment.

GI: Avoid in patients with ileus.

Respiratory: Avoid in patients with respiratory depression.

Question 4

Adverse Effects: Endone (Oxycodone)

Answer 4

Common: Nausea, dyspepsia, drowsiness, dizziness, headache, orthostatic hypotension, itch, dry mouth, miosis, urinary retention, constipation.

Infrequent: Dose-related respiratory depression, bronchospasm, confusion, hallucinations, delirium, agitation, mood changes, tremor, visual disturbances, urticaria, hypothermia, bradycardia or tachycardia, hypertension, ureteric or biliary spasm, paralytic ileus, raised liver enzymes, muscle rigidity, myoclonus (with high doses), flushing due to histamine release (except alfentanil, fentanyl and remifentanil), hypogonadism.

Question 5

Dose: Endone (Oxycodone)

Answer 5

Titrate dose according to response and sedation score.

IV: Initially, 0.5–2 mg; repeat every 3–5 minutes.

Oral: initially 5–15 mg every 4 hours

Question 6

Combination: Endone (Oxycodone) + Naloxone

Answer 6

Naloxone is intended to reduce opioid-induced GI adverse effects such as constipation.

Naloxone: Competitive antagonist at opioid receptors.