Temgesic


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buprenorphine hydrochloride

Buprenex, Burinex (UK), Subutex, Temgesic (UK), Transtec (UK)

Pharmacologic class: Opioid agonist-antagonist

Therapeutic class: Opioid analgesic

Controlled substance schedule III

Pregnancy risk category C

Action

Unclear. May bind to opiate receptors in CNS, altering perception of and response to painful stimuli while causing generalized CNS depression. Also has partial antagonist properties, which may lead to opioid withdrawal effects in patients with physical drug dependence.

Availability

Injection: 300 mcg (0.3 mg)/ml

Tablets (sublingual): 2 mg, 8 mg

Indications and dosages

Moderate to severe pain

Adults: 0.3 mg I.M. or slow I.V. q 6 hours as needed. Repeat initial dose after 30 to 60 minutes.

Children ages 2 to 12: 2 to 6 mcg (0.002 to 0.006 mg)/kg I.M. or slow I.V. q 4 to 6 hours

Opioid dependence

Adults: 12 to 16 mg/day S.L.

Dosage adjustment

• Elderly patients

Contraindications

• Hypersensitivity to drug

• Elderly patients

• MAO inhibitor use within 14 days

Precautions

Use cautiously in:

• increased intracranial pressure (ICP); respiratory impairment; severe renal, hepatic, or pulmonary disease; hypothyroidism; adrenal insufficiency; undiagnosed abdominal pain; prostatic hypertrophy; systemic lupus erythematosus; gout; kyphoscoliosis; diabetes mellitus; alcoholism

• elderly patients

• pregnant or breastfeeding patients

• children younger than age 13.

Administration

• Mix with lactated Ringer's injection, dextrose 5% in water, or normal saline solution.

Give I.V. dose slowly over no less than 2 minutes. Drug may cause respiratory depression (especially initial dose).

• When giving I.M., rotate injection sites to prevent induration and abscess.

• If patient is immobilized, reposition him frequently and keep head of bed elevated.

Adverse reactions

CNS: confusion, malaise, hallucinations, dizziness, euphoria, headache, unusual dreams, psychosis, slurred speech, paresthesia, depression, tremor, agitation, seizures, coma, increased ICP

CV: hypertension, hypotension, palpitations, tachycardia, Wenckebach (Mobitz Type 1) block, bradycardia

EENT: blurred vision, diplopia, amblyopia, miosis, conjunctivitis, tinnitus

GI: nausea, vomiting, constipation, flatulence, ileus, dry mouth

GU: urinary retention

Respiratory: hypoventilation, dyspnea, cyanosis, apnea, respiratory depression

Skin: diaphoresis, pruritus

Other: physical or psychological drug dependence, drug tolerance

Interactions

Drug-drug. Antidepressants, antihistamines, sedative-hypnotics: additive CNS depression

MAO inhibitors: increased CNS and respiratory depression, increased hypotension

Drug-herbs. Chamomile, hops, kava, skullcap, valerian: increased CNS depression

Drug-behaviors. Alcohol use: increased CNS depression

Patient monitoring

• Check hepatic function before and during therapy.

• Monitor respiratory status throughout therapy. Respiratory rate of 12 breaths/minute or less may warrant withholding dose or decreasing dosage.

Patient teaching

• Instruct patient to move slowly when sitting up or standing, to avoid dizziness or light-headedness from sudden blood pressure drop.

• Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness.

• Advise patient to increase daily fluid intake to help prevent constipation.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, herbs, and behaviors mentioned above.

McGraw-Hill Nurse's Drug Handbook, 7th Ed. Copyright © 2013 by The McGraw-Hill Companies, Inc. All rights reserved

Temgesic

A brand name for BUPRENORPHINE.
Collins Dictionary of Medicine © Robert M. Youngson 2004, 2005
References in periodicals archive ?
The dominant groups used injection pentazocin (sosegon) and buprenorphine (temgesic) for addiction purposes6.
For postoperative pain, intramuscular buprenorphine hydrochloride (Temgesic 0.15 mg/kg, Shering-Plough, Sandton, South Africa) was available at the discretion of the consultant veterinarian.
For pain control buprenorphine (Temgesic 0.3mg [ml.sup.-1]--Cloridrato de Buprenorfina--Schering-Plough - Rio de Janeiro, RJ, Brasil) was administered subcutaneously in the dosage of 0.01 mg [kg.sup.-1] every 12 hours for five consecutive days.
Also taken were morphine, Temgesic, Fentenyl patches and Dexedryne as well as Ritalin and Equsyn, which are used for treating attention deficit hyperactivity disorder.
They include nine boxes of methadone containing 60 tablets each, morphine, 180 boxes of Filnarine which are morphine sulphate tablets in various colours, Temgesic, and Fentenyl patches which are pain killers.
He sold Temgesic or 'jellies' , as the inmates call them, to anyone with the capability of buying them.
"He takes smack and Temgesic and if he denies that he is a liar."
(Amgros, Copenhagen, Denmark), systemic Rompun (1.0-1.2 ml Vet, Bayer, Germany), and Temgesic (0.60.7 ml, Reckitt Benckiser, Hull, UK).
Buprenorphine (0.05 mg/kg, s.c.; Temgesic, Schering-Plough, Kirkland, QC, Canada) was given at the end of surgery and every 8 hours for 2 days to maintain postoperative analgesia.
Buprenorphine (45 [micro]g/kg Temgesic (Reckitt Benckiser, Berkshire, England)) was given three times daily (7 AM, 3 PM, and 11 PM) from time of inoculation until euthanasia.
When necessary, 50 [micro]g/kg buprenorphine (Temgesic, Essex Pharma, MUnchen, Germany) was injected intramuscularly as postoperative analgesic.