Home Drug Guide Propoxyphene Napsylate

Drug Guide

Generic Name

Propoxyphene Napsylate

Brand Names Darvon-n W/ ASA

Classification

Therapeutic: Analgesic, Pain Reliever

Pharmacological: Narcotic (opioid) analgesic

FDA Approved Indications

  • Management of mild to moderate pain

Mechanism of Action

Propoxyphene is a centrally acting narcotic analgesic that modulates pain perception in the brain through its affinity for the μ-opioid receptor. It also has a weak local anesthetic effect.

Dosage and Administration

Adult: Typically 65-130 mg every 4 hours as needed; maximum daily dose varies by formulation.

Pediatric: Not recommended due to safety concerns.

Geriatric: Use with caution; lower initial doses recommended due to increased sensitivity and risk of adverse effects.

Renal Impairment: Dose adjustment recommended; avoid in severe impairment.

Hepatic Impairment: Use with caution; monitor for increased effects.

Pharmacokinetics

Absorption: Rapidly absorbed from the gastrointestinal tract.

Distribution: Extensively bound to plasma proteins.

Metabolism: Extensively metabolized in the liver, primarily by conjugation.

Excretion: Excreted mainly in urine.

Half Life: Approximately 3-4 hours.

Contraindications

  • Hypersensitivity to propoxyphene or acetaminophen
  • Use in respiratory depression, acute intoxication with alcohol or other CNS depressants.
  • History of addiction or dependence on opioids.

Precautions

  • Use cautiously in patients with impaired hepatic or renal function, elderly, or those with a history of addiction. Due to safety concerns, its use has been widely restricted or discontinued in many countries.

Adverse Reactions - Common

  • Dizziness, drowsiness (Common)
  • Nausea, vomiting (Common)
  • Constipation (Common)

Adverse Reactions - Serious

  • Respiratory depression (Rare)
  • Cardiac arrhythmias (Rare)
  • Adverse cardiovascular events (Rare)

Drug-Drug Interactions

  • CNS depressants (alcohol, sedatives, tranquilizers)
  • MAO inhibitors
  • Other opioids

Drug-Food Interactions

  • Alcohol enhances sedative effects

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor pain relief, respiratory status, consciousness level.

Diagnoses:

  • Risk for respiratory depression
  • Impaired physical mobility due to sedation

Implementation: Administer with food to reduce gastric irritation; monitor vital signs closely.

Evaluation: Assess pain relief, watch for signs of adverse effects, especially respiratory depression.

Patient/Family Teaching

  • Do not exceed prescribed dose.
  • Avoid alcohol and CNS depressants.
  • Report signs of respiratory distress or allergic reactions.
  • Caution regarding activities requiring alertness.

Special Considerations

Black Box Warnings:

  • Potential for addiction, abuse, and misuse.

Genetic Factors: Genetic variations can affect metabolism, potentially altering efficacy and risk.

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

Overdose Management

Signs/Symptoms: Respiratory depression, pinpoint pupils, unconsciousness, cyanosis.

Treatment: Administer naloxone for respiratory depression, supportive care, ensure airway patency, monitor vital signs.

Storage and Handling

Storage: Store in a 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.