Guest guest Posted May 14, 2003 Report Share Posted May 14, 2003 , Oxycontin is specifically designed as a " sustained release " drug, to be taken every 12 hours. Which is to say that the effects of Oxycontin last for 12 hours. If your son is taking 10 mg. every 6 hours; which isn't advised, he is taking what is 'equivalent' to taking 20 mg. of Oxycontin at 12 hours intervals. Hope this information will be of help to you. J:O)hn ----------------------------------------------------------- What is Oxycontin? OxyContin (Oxycodone hydrochloride controlled-release) is an opioid analgesic in time-release form. Which means a small amount of the drug is absorbed over a 12 hour period. The active ingredient in Oxycontin is Oxycodone which is the main ingredient in Percocet, Percodan, Tylox, Roxicet, Oxycocet, OxyIR, Endodan, Endocet and probably a few more names not mentioned. Oxycodone has been around for years and is used for moderate to severe pain. It is a Schedule II controlled substance. It works by inhibiting ascending pain pathways in the Central Nervous System, increases the pain threshold, and alters pain perception. The problem with Oxycodone is after using it for a while the body develops a natural tolerance to the medication, as it does with all opiates. In order to get the same affect the person needs to increase the dose. This does not mean the person is addicted. There is a difference between tolerance and addiction. The problem that chronic pain sufferers have with opiates is the need to increase the dose to get the same affect. Before Oxycontin came along the patient would increase there dose as tolerance developed and this increased the risk of side effects of the other ingredient in the medication. For example: Percocet contains Oxycodone 5mg with Acetaminophen 325mg. Increasing the dose of this medication also increases the dose of Acetaminophen that the person gets. Another downfall of fast acting medications is that you get a peak affect in 2 hours and then a sudden drop of the medication. So the patient was unable to keep a steady level of the drug in their system. In the past in order to get adequate pain relief, the patient would have to switch to another medication and found it did not work as well as the Oxycodone. In 1996 the Purdue Pharmaceutical company came out with the Oxycontin, the first oxycodone pain medication that is time released (MSContin is also made by Purdue and is a time released form of Morphine). These are the only two opiate pain relievers available in a sustained released formula. With Oxycontin the patient can get Oxycodone (A very effective medication for pain) in a sustained released formula without the adverse affects of acetaminophen or aspirin that is in many of the fast acting formulas. It releases small amounts of Oxycodone over 12 hours, keeping the therapeutic levels of this drug in the blood stream. This was a Godsend for pain patients. For the first time they could get adequate pain control in a sustained released product. This gave many patients a new outlook on life. For many this was the first time they were able to get through their day Painfree! Because it is sustained released it does not cause an elevation in medication blood levels like the fast acting drugs do. It keeps a steady, constant level of Oxycodone in the bloodstream, resulting in adequate pain relief. Contrary to popular belief you do not need to be a Cancer patient to take Oxycontin. It works very effectively for patients suffering with chronic pain. Most of these patients try hundreds of other medications before finally deciding to go on Opiate treatment. Contrary to popular belief, patients who take Oxycontin are not junkies, drug seekers, drug addicts or poor. They are normal people who suffer with a condition that causes excruciating daily pain and have tried everything to try and control this pain. They are your mothers, children, neighbors and friends. All they want is to be able to live their lives without pain. What Dose of Oxycontin is safe? OxyContin is supplied in 10 mg, 20 mg, 40 mg, 80 mg, and 160 mg tablet strengths. The tablet strengths describe the amount of Oxycodone per tablet. The medication is sustained released and lasts for 12 hours. The pills are given every 12 hours in order to keep a constant level of the drug in the system. Oxycontin should not be used for quick pain relief. It should be used by those patients who suffer with chronic daily pain that is moderate to severe. It is not for mild pain or for temporary pain, such as after dental or surgical procedures. Each patient has to be dosed individually. What works for one patient may not work for another. This is true for all the opiates. Physicians start out with the lowest dose and gradually increase that dose until they reach the point of pain relief. There are different criteria for different people. It depends on age, weight, type of pain, history of taking opiate's in the past. In a person who has never taken opiates they start them on the absolute lowest dose. In a person who has been on opiates in the past the starting dose will be higher. Oxycontin was produced to provide a time release of the active ingredient - oxycodone. The pills should not be broken in half, crushed, snorted, or injected. Doing this could cause a fatal dose of the medication to be released suddenly. ---------------------------------------------------------------------------- ---- How it works OxyContin is an opioid agonist. Opioid agonists are substances that act by attaching to specific proteins called opioid receptors, which are found in the brain, spinal cord, and gastrointestinal tract. When these drugs attach to certain opioid receptors in the brain and spinal cord they can effectively block the transmission of pain messages to the brain. ---------------------------------------------------------------------------- ---- What are the side effects? Side effects/Adverse Reactions CNS: Drowsiness, dizziness, confusion, headache, sedation, euphoria GI: Nausea, vomiting, anorexia, constipation, cramps. GU Increased urinary output, dysuria, urinary retention INTEG: Rash, urticaria, bruising, flushing, diaphoresis (Sweating), pruritus (itching) EENT: Tinnitus, blurred vision, miosis, diplopia CV: Palpitations, bradycardia, change in BP RESP: Respiratory depression Contraindications Hypersensitivity, addiction (narcotic) Precautions Addictive personality, pregnancy (, lactation, increased intracranial pressure, MI (Acute), severe heart disease, respiratory depression, hepatic disease, renal disease, child <18. Pharmacokinetics Detoxified by the liver, excreted in the urine, crosses placenta, excreted in breast milk. Interactions Increased effects with other CNS depressants: Alcohol, narcotics, sedative/hypnotics, antipsychotics, skeletal muscle relaxants. Lab Test Interference Increases Amylase Overdosage Signs and Symptoms: Serious overdose of oxycodone HCl is characterized by respiratory depression (a decrease in respiratory rate and/or tidal volume, Cheyne-Stokes respiration, cyanosis), extreme somnolence, progressing to stupor or coma skeletal muscle flaccidity, cold and clammy skin, and sometimes bradycardia and hypotension. In serious overdosage, apnea, circulatory collapse, cardiac arrest, and death may occur. Treatment: Primary attention should be given to the reestablishment of adequate respiratory exchange through provision of a patent airway and the institution of assisted or controlled ventilation. The narcotic antagonist naloxone is a specific antidote against respiratory depression which may result from overdose or unusual sensitivity to narcotics, including oxycodone. Therefore, an appropriate dose: 0.4 mg should be administered, preferably by the IV route, simultaneously with efforts at respiration resuscitation. Since the duration of action of oxycodone may exceed that of the antagonist, the patient should be kept under continued surveillance and repeated doses of the antagonist should be administered as needed to maintain adequate respiration. An antagonist should not be administered in the absence of clinically significant respiratory or cardiovascular depression. Oxygen, IV fluids, vasopressors and other supportive measures should be employed as indicated. Gastric emptying may be useful in removing unabsorbed drug. ---------------------------------------------------------------------------- ---- Nursing Considerations Assess I & O ratio; check for decreasing output; may indicate urinary retention CNS changes: dizziness, drowsiness, hallucinations, euphoria, LOC, pupil reaction Allergic reactions: rash, urticaria - NOTE* These type of pain relievers cause a release of histamine which can cause itching. This is a normal body response to the increase in histamine and not an allergic reaction. This symptom goes away after a few days of use. Rash and hives with the itching is a sign of allergic reaction. Respiratory dysfunction: respiratory depression, character, rate, rhythm; notify prescriber if respirations are <10/min Need for pain medication by pain, sedation scoring; physical dependence. Administer With antiemetic if nausea, vomiting occur Do not break or crush tablets. Tablets should be give whole! You may need to give short acting pain medications for breakthrough pain. Usually OxyIR is used. If the patient needs more than 2 OxyIR, daily for breakthrough pain then a re-evaluation of the maintenance dose should be done. Perform/Provide Support, support and more support. Reassure the patient that the need for an increase in medication does not mean that they are addicted to the medication. Reassure them that a natural " tolerance " develops with time. Reinforce this with family members. Safety measures: Side rails, nightlight, call bell within easy reach. Evaluate Therapeutic response: Decrease in pain. Treatment of Overdose Naloxone (Narcan) 0.2-0.8mg IV, O2, IV fluids, vasopressors. Teach patient/family To report any symptoms of CNS changes, allergic reactions. That physical dependency may result from extended use. That withdrawal symptoms may occur if they suddenly stop their medication: nausea, vomiting, cramps, fever, faintness, anorexia. ---------------------------------------------------------------------------- ---- Information from the Manufacturer Package Insert for Oxycontin *Must have Adobe Acrobat Reader to view this page. http://www.oxycontin.com/news/docs/L4909-BS.pdf Frequently Asked Questions About the Illegal Abuse and Diversion of OxyContin Tablets http://www.oxycontin.com/news/docs/Oxy_faqs.htm Purdue Pharma Statement on Abuse and Diversion of OxyContin® Updated March 31, 2001 http://www.oxycontin.com/news/docs/OxyContin_Statement_010301.htm Purdue Pharma Statement on DEA Program to Reduce Diversion of OxyContin Tablets May 4, 2001] http://www.oxycontin.com/news/docs/DEA_Statement_2_050401.htm Purdue letter to healthcare professionals In PDF format - must have Adobe Acrobat Reader to view this page. http://www.oxycontin.com/news/docs/PurdueLetterHealthcarePro.pdf Oxycontin Package insert updated July 18, 2001 http://www.oxycontin.com/news/docs/oxyPackageInsert.pdf Proper use VS Criminal abuse - The role of Oxycontin tablets in Pain Treatment http://www.oxycontin.com/news/docs/20010730-02.htm ---------------------------------------------------------------------------- ---- Important Information on Abuse I'm sure every American has read at least one story in their local newspaper or seen at least one news report on the illegal use of Oxycontin. Oxycontin was made to provide patients with Chronic pain a way to get their medication in a time released form and does work when used correctly. When it becomes a problem is when the tablets are crushed, broken, snorted, injected or the higher dose tablets are taken by someone who has never taken opiates before. This is dangerous and could lead to death! Their was a tragic story on the news about 2 sixteen year old girls who took one of the higher dose tablets, went to bed, and never woke up. PLEASE educate your children on the dangers of this medication if used improperly. Even if taken whole - the doses can be too high for someone who has never taken opiates before in their life. When these tablets are crushed it is even more detrimental. Percocet contains 5mg of Oxycodone - One 80 Mg Oxycontin contains the equivalent of 16 Percocet. When crushed it is like taking 16 Percocet at one time. One 160mg tablet is equivalent to 32 Percocet. So when used illegally and crushed it is like taking a whole bottle of Percocet at once. I don't think anyone in their right mind would do this. This is how dangerous this can be! For pain patients it is a life saver. For people using it illegally it can cause death. For an excellent resource for children and teens go the the Painfully Obvious Website http://www.painfullyobvious.com/html/home/home.html which was created by the Purdue Pharmaceutical company to help educate children and teens on the dangers of prescriptions drug abuse. It contains teaching tools for teachers and leaders who would like to use it to educate children and also information, games and free stuff for children. Quote Link to comment Share on other sites More sharing options...
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