Home Drug Guide Oxycodone

Drug Guide

Generic Name

Oxycodone

Brand Names Xtampza ER

Classification

Therapeutic: Analgesic, Opioid

Pharmacological: Mu-opioid receptor agonist

FDA Approved Indications

  • Management of pain severe enough to require an opioid analgesic and for which alternative treatment options are inadequate

Mechanism of Action

Oxycodone binds to mu-opioid receptors in the central nervous system, altering the perception of and response to pain, and producing analgesic effects.

Dosage and Administration

Adult: Dose individualized based on severity of pain, previous analgesic experience, and patient response. Usually 10-20 mg every 12 hours, titrated gradually.

Pediatric: Not established for children under 18 years.

Geriatric: Start at the low end of dosing range; monitor for respiratory depression and sedation.

Renal Impairment: Adjust dosage carefully; monitor for enhanced sensitivity to opioids.

Hepatic Impairment: Use with caution; dosage adjustments may be necessary due to reduced metabolism.

Pharmacokinetics

Absorption: Well absorbed; food may slightly delay absorption.

Distribution: Distributed extensively in body tissues, bound approximately 45% to plasma proteins.

Metabolism: Primarily metabolized in the liver via CYP3A4 and CYP2D6 pathways.

Excretion: Excreted mainly in urine as metabolites; small amount unchanged in urine.

Half Life: Approximate plasma half-life of 4.5 hours.

Contraindications

  • Significant respiratory depression, acute or severe bronchial asthma in an unmonitored setting, known hypersensitivity to oxycodone.

Precautions

  • Use with caution in elderly, hepatic or renal impairment, head injuries, increased intracranial pressure, and in patients with a history of substance abuse.

Adverse Reactions - Common

  • Nausea (Common)
  • Dizziness (Common)
  • Constipation (Common)
  • Drowsiness (Common)

Adverse Reactions - Serious

  • Respiratory depression (Rare but serious)
  • Circulatory depression (Rare)
  • Allergic reactions including rash, pruritus (Rare)

Drug-Drug Interactions

  • CNS depressants, hypnotics, sedatives, other opioids, MAO inhibitors

Drug-Food Interactions

N/A

Drug-Herb Interactions

  • St. John’s Wort

Nursing Implications

Assessment: Assess pain prior to and following administration; monitor for oversedation and respiratory depression.

Diagnoses:

  • Risk for respiratory depression
  • Ineffective airway clearance

Implementation: Use the lowest effective dose for the shortest duration; monitor respiratory status closely.

Evaluation: Pain relief without significant side effects.

Patient/Family Teaching

  • Take exactly as prescribed; do not alter dose or frequency.
  • Warn about sedation, dizziness, and the risk of dependence.
  • Advise against alcohol consumption and use of CNS depressants.
  • Store securely to prevent misuse.

Special Considerations

Black Box Warnings:

  • Addiction, abuse, and misuse can lead to overdose and death.
  • Respiratory depression is the most serious complication.

Genetic Factors: Genetic variability in CYP2D6 enzymes can affect metabolism and response.

Lab Test Interference: None significant.

Overdose Management

Signs/Symptoms: Respiratory depression, extreme drowsiness, muscle limpness, unconsciousness.

Treatment: Administer naloxone as soon as possible; support respiratory function; establish airway and provide ventilation as needed.

Storage and Handling

Storage: Store in tightly closed container at room temperature, away from moisture, heat, and light.

Stability: Stable under recommended storage conditions.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.