Home Drug Guide Pentazocine Hydrochloride

Drug Guide

Generic Name

Pentazocine Hydrochloride

Brand Names Talwin 50

Classification

Therapeutic: opioid analgesic

Pharmacological: kappa-opioid receptor agonist and weak mu-opioid receptor antagonist

FDA Approved Indications

  • Moderate to severe pain management

Mechanism of Action

Pentazocine binds predominantly to kappa-opioid receptors producing analgesia, and weakly blocks mu-opioid receptors, which may diminish some opioid effects and reduce potential for dependence.

Dosage and Administration

Adult: 50 mg every 3 to 4 hours as needed, not to exceed 360 mg per day.

Pediatric: Not typically recommended for children.

Geriatric: Start at lower end of dosing range; monitor closely due to potential increased sensitivity and comorbidities.

Renal Impairment: Use with caution, adjustments based on clinical response and renal function.

Hepatic Impairment: Use with caution; hepatic impairment may alter drug metabolism.

Pharmacokinetics

Absorption: Rapidly absorbed after IM or subcutaneous injection.

Distribution: Widely distributed, crosses blood-brain barrier.

Metabolism: Metabolized in the liver via conjugation.

Excretion: Excreted mainly via urine.

Half Life: Approximately 2 to 4 hours.

Contraindications

  • History of hypersensitivity to pentazocine or other opioids.
  • Significant respiratory depression.
  • Head injury or increased intracranial pressure.

Precautions

  • Use with caution in patients with substance abuse history, during labor, or in patients with liver impairment. Risk of dependence and abuse exists.

Adverse Reactions - Common

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

Adverse Reactions - Serious

  • Respiratory depression (Uncommon)
  • Hypotension (Uncommon)
  • Psychotomimetic effects (e.g., hallucinations) (Rare)

Drug-Drug Interactions

  • Alcohol, sedatives, tranquilizers may increase sedation and respiratory depression.
  • MAO inhibitors may enhance adverse effects.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Assess pain relief, respiratory status, and level of consciousness before and during therapy.

Diagnoses:

  • Risk for respiratory depression
  • Risk for addiction
  • Impaired comfort

Implementation: Administer cautiously, verify dose, monitor vital signs and pain levels regularly.

Evaluation: Evaluate effectiveness of pain relief and monitor for adverse effects.

Patient/Family Teaching

  • Take medication exactly as prescribed.
  • Do not exceed prescribed dose.
  • Rise slowly to avoid dizziness.
  • Report signs of respiratory depression or allergic reactions.
  • Avoid alcohol and sedatives.

Special Considerations

Black Box Warnings:

  • Risk of addiction, abuse, and misuse leading to overdose and death.
  • Respiratory depression risk.

Genetic Factors: Genetic variations may influence metabolism and response.

Lab Test Interference: May interfere with certain lab tests, such as those measuring hepatic or renal function.

Overdose Management

Signs/Symptoms: Respiratory depression, extreme drowsiness, hypotension, coma.

Treatment: Support airway, provide oxygen, administer naloxone if respiratory depression occurs, provide ventilatory support if needed.

Storage and Handling

Storage: Store at controlled room temperature, 20-25°C (68-77°F).

Stability: Stable under standard conditions; avoid excessive moisture or heat.

🛡️ 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.