Oxycodone Overview and Dosage Guidelines
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Questions and Answers

What should a patient do if they experience difficulty staying awake while on medication?

  • Reduce the dosage without consulting anyone
  • Increase the medication intake to counteract sleepiness
  • Consult a GP as soon as possible (correct)
  • Continue taking the medication as prescribed

    • What effect does alcohol consumption have when taken with the medication?

  • It should be combined to enhance therapeutic effects
  • It has no effect on the medication
  • It may lessen the effectiveness of the medication
  • It can increase the effects of the medication (correct)

    • Which of the following is a recommendation for managing side effects related to medication?

  • Maintain regular hydration (correct)
  • Avoid dental check-ups to prevent anxiety
  • Sleep in a sitting position at all times
  • Only drink coffee to stay awake

    • What adjustment should be made when changing posture to prevent dizziness?

    <p>Stand up and change posture slowly</p> Signup and view all the answers

    Which medication interaction is specified in the content?

    <p>Rifampicin increases buprenorphine metabolism</p> Signup and view all the answers

    What is recommended to prevent constipation while on medication?

    <p>Use laxatives such as Coloxyl with Senna</p> Signup and view all the answers

    What dental care recommendation is provided for long-term users of the medication?

    <p>Regular dental checks due to risk of dry mouth</p> Signup and view all the answers

    Why is it important to have take-home naloxone available?

    <p>It acts as an antidote in case of overdose</p> Signup and view all the answers

    Which medications should be avoided in combination due to increased CNS side effects?

    <p>Benzodiazepines</p> Signup and view all the answers

    In which condition should oral administration be avoided due to limited drug absorption?

    <p>Ileus</p> Signup and view all the answers

    What is one of the key physiological parameters to monitor while using this medication?

    <p>Blood pressure</p> Signup and view all the answers

    What is the recommended onset time for peak analgesia after oral administration of conventional liquid?

    <p>60 minutes</p> Signup and view all the answers

    Which of the following should be performed regularly as part of patient monitoring?

    <p>Dental checks</p> Signup and view all the answers

    For a patient weighing 25 kg, what is the correct dosage for administration three times daily?

    <p>2.5 mg tds</p> Signup and view all the answers

    What is the maximum recommended daily dose for chemotherapy-induced nausea/vomiting?

    <p>30 mg</p> Signup and view all the answers

    What is the recommended dose for a patient over 20 kg experiencing gastric stasis?

    <p>5-10 mg tds</p> Signup and view all the answers

    What should be assessed regularly in patients taking this medication to prevent falls?

    <p>Fall risk</p> Signup and view all the answers

    What is the preferred route of administration for patients with ileus?

    <p>Intravenous</p> Signup and view all the answers

    What is a potential side effect of medication that involves histamine release?

    <p>Flushing</p> Signup and view all the answers

    Which dosage adjustment is recommended for patients with a creatinine clearance (CrCl) of 10-30 mL/min?

    <p>75% of normal dose</p> Signup and view all the answers

    What is advised to patients regarding driving while on medication that causes drowsiness and dizziness?

    <p>Avoid driving until knowing effects</p> Signup and view all the answers

    What initial dose is suggested for acute pulmonary edema in elderly patients?

    <p>1 mg</p> Signup and view all the answers

    If a patient has renal impairment and a creatinine clearance of under 10 mL/min, what dosing should be considered?

    <p>Carefully monitor dosage and reduce if necessary</p> Signup and view all the answers

    What condition is known to be a serious allergic reaction that requires immediate medical attention?

    <p>Anaphylaxis</p> Signup and view all the answers

    What is the maximum daily dosage for acute pain in patients aged 1-12 years when using conventional dosing?

    <p>50 mg</p> Signup and view all the answers

    For patients with a creatinine clearance of 10-50 mL/min, what is the recommended reduction in daily dose?

    <p>Reduce to ½-¾ of the daily dose</p> Signup and view all the answers

    Which of the following is NOT a possible adverse effect related to medication use?

    <p>Increased heart rate</p> Signup and view all the answers

    Which of the following symptoms is an example of opioid induced hyperalgesia?

    <p>Increased pain sensation</p> Signup and view all the answers

    What is the primary indication for oxycodone?

    <p>Severe acute/chronic pain</p> Signup and view all the answers

    What are potential effects of oxycodone in newborns when used during pregnancy?

    <p>Respiratory depression and withdrawal effects</p> Signup and view all the answers

    Which of the following dosing routes is NOT typically used for acute pain with oxycodone?

    <p>Inhalation</p> Signup and view all the answers

    What is a typical initial dose of oxycodone for a patient over 70 years old experiencing acute pain?

    <p>0.5-1 mg</p> Signup and view all the answers

    In what scenario is monitoring for adverse drug reactions crucial when administering oxycodone?

    <p>In preterm infants or those less than 4 weeks old</p> Signup and view all the answers

    Which side effect is associated with oxycodone use?

    <p>Constipation</p> Signup and view all the answers

    When transitioning a patient to chronic non-cancerous pain management with oxycodone, what is the initial oral CR dose?

    <p>5-10 mg BD</p> Signup and view all the answers

    What should be done if a patient shows poor response while taking over 30 mg of oxycodone daily?

    <p>Taper down slowly and consider stopping</p> Signup and view all the answers

    Which side effect of oxycodone is most concerning and dose-related?

    <p>Respiratory depression</p> Signup and view all the answers

    For oral administration of oxycodone in adults, what is the starting dose?

    <p>5-15 mg every 4 hours</p> Signup and view all the answers

    What is a significant side effect that can occur with the use of oxycodone?

    <p>Itch</p> Signup and view all the answers

    What dosing option is indicated for acute pain in a subcutaneous administration of oxycodone for a patient weighing less than 40 kg?

    <p>7.5-12.5 mg q2h</p> Signup and view all the answers

    Which of these side effects is NOT commonly associated with oxycodone?

    <p>Heightened alertness</p> Signup and view all the answers

    Study Notes

    Oxycodone

    • Oxycodone is an opioid used for severe acute and chronic pain.

    • Pregnancy: Oxycodone may cause respiratory depression in newborns and withdrawal effects in neonates.

    • Breastfeeding: Occasional oxycodone doses are considered safe for breastfeeding mothers. Repeated doses in preterm infants or those under 4 weeks old should be monitored for adverse drug reactions and sedation.

    Dosage

    • Acute Pain:

      • IV: 0.5-2 mg every 3-5 minutes. Dose adjustments are needed for patients older than 70 years.
      • SC:
        • Below 40 kg: 7.5-12.5 mg every 2 hours.
        • 40-60 kg: 5-10 mg every 2 hours.
        • 60-70 kg: 2.5-7.5 mg every 2 hours.
        • 70-85 kg: 2.5-5 mg every 2 hours.
        • Above 85 kg: 2-3 mg every 2 hours.
      • PO: 5-15 mg every 4 hours for adults.

    • Chronic Cancer Pain:

      • PO: 2.5-5 mg every 4-6 hours.
      • Maintenance:
        • PO: Half of the total daily amount every 12 hours.
        • SC Infusion: Half of the total daily oral amount every 24 hours.

    • Chronic Non-Cancerous Pain:

      • PO: 5-10 mg twice daily (start with 5 mg for opioid-naïve patients or elderly). Review every 2 weeks.
      • Poor Response: If pain is not adequately controlled with greater than 30 mg daily, the dosage should be slowly tapered down and discontinued .
      • Rectal: 30 mg every 6-8 hours as needed.

    Side Effects

    • Sedation
    • Dizziness
    • Headache
    • Orthostatic hypotension
    • Itch
    • Dry mouth
    • Urinary retention
    • Miosis (excessive pupil constriction)
    • Respiratory depression (dose-related)
    • Constipation
    • Nausea
    • Vomiting
    • Altered mood state (e.g., confusion)
    • Opioid-induced hyperalgesia
    • Dyspepsia (indigestion)
    • Flushing (due to histamine release)
    • Anaphylaxis
    • Seizure

    Practice Points

    • Renal Impairment:

      • CrCl 10-30 mL/min: Initially ¾ of the normal dose.
      • CrCl < 10 mL/min: ¾ of the normal daily dose.
      • CrCl > 30 mL/min: Monitor the patient's response and adjust dosage accordingly.

    • Acute Pain (1-12 years): Avoid giving a total daily dosage exceeding 50 mg (consider lower doses in elderly patients). Taper down slowly and discontinue medication if daily dosages exceed 30 mg.

    • Acute Pulmonary Edema: 1-5 mg IV (1 mg for elderly).

    • Renal Impairment:

      • CrCl 10-50 mL/min: ½ - ¾ of the daily dose.
      • CrCl < 10 mL/min: Consult a specialist for guidance and dosage adjustment..

    • General Precautions:

      • Oxycodone may make you feel drowsy and dizzy; avoid driving and operating machinery until you know you're affected.
      • Avoid alcohol consumption as it may enhance the effects of oxycodone.
      • If you experience difficulty staying awake or feel excessively sleepy, stop taking the medication and consult your doctor immediately.
      • Stand up and alter posture gradually, as abrupt changes can lead to dizziness.
      • Regular dental checkups are recommended as prolonged use can increase the risk of dry mouth and dental caries.
      • Aim for adequate hydration.
      • Consider using laxatives, such as Coloxyl with Senna, to prevent constipation.
      • Provide take-home naloxone education and access.

    Drug Interactions

    • Rifampicin: Increases buprenorphine metabolism.

    Contraindications/Complications

    • Combination Use: Combining oxycodone with benzodiazepines and gabapentinoids should be avoided due to an increased risk of central nervous system (CNS) side effects and respiratory depression.
    • Ileus: Oral administration is associated with limited drug absorption in patients with ileus. Parenteral routes are preferred.

    Monitoring

    • Blood pressure
    • Respiratory function
    • Regular dental checkups
    • Liver enzyme levels
    • Regular fall risk assessment

    Notes

    Peak analgesia from oxycodone can be expected after:

    • Conventional PO Liquid: 60 minutes.
    • SC: 50-90 minutes.

    Pediatric Dosing

    • 60 kg: 10 mg three times daily.
    • 30-60 kg: 5 mg three times daily.
    • 20-30 kg: 2.5 mg three times daily.
    • 15-20 kg: 2 mg 2-3 times daily.
    • 10-15 kg: 1 mg 2-3 times daily.

    Special Considerations

    • Chemotherapy-Induced Nausea/Vomiting: PO/IV 10 mg three times daily (max 30 mg daily).
    • Gastric Stasis: For patients weighing over 20 kg, PO/IV/IM 5–10 mg three times daily.
    • Intubation of the Intestine: For patients over 20 kg, IV 10-20 mg as a single dose.
    • Renal Impairment: For patients with CrCl < 10 mL/min, consult a specialist for guidance on dosage adjustment.

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    PHRM3102 OSCE PMF - Oxycodone

    Description

    This quiz covers key information about oxycodone, an opioid used for severe pain management. It includes important considerations for use during pregnancy and breastfeeding, as well as detailed dosage recommendations for acute and chronic pain. Test your knowledge on this vital medication and its safe application.

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