Home Drug Guide Pentazocine Lactate

Drug Guide

Generic Name

Pentazocine Lactate

Brand Names Talwin

Classification

Therapeutic: Analgesic, Opioid

Pharmacological: Agonist-at-Opioid Receptor

FDA Approved Indications

  • Management of moderate to severe pain

Mechanism of Action

Pentazocine is a mixed agonist-antagonist opioid that acts primarily as an agonist at kappa-opioid receptors and as an antagonist or partial agonist at mu-opioid receptors, producing analgesia with less respiratory depression compared to full mu-opioid agonists.

Dosage and Administration

Adult: 50 mg every 3 to 4 hours as needed; maximum dose varies with clinical response.

Pediatric: Use not generally recommended; refer to specific pediatric guidelines.

Geriatric: Start with lower doses due to increased sensitivity; monitor closely.

Renal Impairment: Adjust dose based on severity of impairment; cautious use.

Hepatic Impairment: Adjust dose as hepatic metabolism may be reduced.

Pharmacokinetics

Absorption: Well absorbed intramuscularly and subcutaneously.

Distribution: Widely distributed; crosses the blood-brain barrier.

Metabolism: Metabolized in the liver.

Excretion: Excreted mainly via the kidneys.

Half Life: Approximately 3 hours.

Contraindications

  • Known hypersensitivity to pentazocine or other opioids.
  • Respiratory depression, significant respiratory compromise.

Precautions

  • Use with caution in patients with a history of substance abuse, head injury, increased intracranial pressure, hepatic impairment, or cardiovascular disease. May cause drug dependence.

Adverse Reactions - Common

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

Adverse Reactions - Serious

  • Respiratory depression (Serious, rare with proper dosing)
  • Collaboration of dependence or abuse (Serious)
  • Hypotension (Possible)

Drug-Drug Interactions

  • CNS depressants (e.g., alcohol, benzodiazepines) increase sedative effects.
  • MAO inhibitors may enhance respiratory depression and hypotension.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Assess pain level before and after administration. Monitor respiratory rate closely.

Diagnoses:

  • Pain, Risk for opioid addiction, Ineffective breathing pattern.

Implementation: Administer with caution, observe for signs of respiratory depression, and assess pain relief.

Evaluation: Evaluate effectiveness of pain control and any adverse effects.

Patient/Family Teaching

  • Instruct patients to avoid alcohol and sedatives.
  • Report signs of respiratory depression, excessive sedation, or allergic reactions.
  • Use medication only as prescribed.

Special Considerations

Black Box Warnings:

  • Respiratory depression risk, especially in opioid-naive patients and when combined with other CNS depressants.

Genetic Factors: Polymorphisms in opioid receptor genes may affect response.

Lab Test Interference: May interfere with certain laboratory tests related to liver function.

Overdose Management

Signs/Symptoms: Respiratory depression, somnolence, hypotension, possible coma.

Treatment: Administer opioid antagonist naloxone immediately, provide supportive respiratory and cardiovascular care.

Storage and Handling

Storage: Store at room temperature, away from light and moisture.

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.