Drug Interaction:
Interactions - summary-
Morphine +
Cationic drugs Morphine with Metformin
Cationic drugs( eg amiloride, digoxin, morphine, procainamide,
quinidine, quinine, ranitidine, triamterene, trimethoprim, vancomycin)
that are eliminated by renal tubular secretion, theorically have the
potential for interaction with metformin by competing for common
renal transport systems.Although such interactions are theoritical,
careful patient monitoring and dose adjustment of metformin or
interfering drug is recommended
Narcotics Barbiturate Anesthetic
barbiturate dose required to induce anesthesia may be reduced. Apnea may
be more common with combination
Barbiturate Narcotics
barbiturates may decrease the animicrosomal effectiveness of metronidazole
Other CNS depressants, MAO inhibitors. Alcohol, long acting muscle relaxants.
Indication:
Moderate to severe pain.
Adverse Reaction:
Respiratory depression,shock. Dysphoric reactions,toxic psychosis,convulsions.
Nausea, vomiting,constipation,
Urinary retension,
Headache,anxiety,
Hyperthermia or hypothermia,
Pruritus, wheals, urticaria,
Tachycardia, bradycardia,
Syncope changes in blood pressure, muscle tremor,
Blurred vision,
Nystagmus, miosis, dependency.
Contra-Indications:
Respiratory depression,paralytic ileus,delayed gastric emptying,
Obstructive airways disease,
Acute liver disease,morphine sensitivity.
Use with MAO inhibitors concomittantly or 2 weeks after stopping them.
Pregnancy and lactation, children.
Special precautions:
Elderly,
Hyperthyroidism,
Renal and chronic liver disease,suspected paralytic ileus,
Head injury, intracranial lesions or pre-existing increase in intracranial pressure,
Hypotension, circulatory shock,
Seizure-prone patients.
Dosages/ Overdosage Etc:
Indications:
Moderate to severe pain.
Dosage:
Oral administration is 1/2 to 1/6 as effective as parentral administration.
Oral - 10 to 30mg every 4 hours
Controlled release- 30mg every 8 to 12 hours
IV- Adults- 2.5 to 15mg/70kg in 4 to 5ml of water for injection,administered over 4 to 5 minutes.
Patient Information:
1.May cause drowsiness,dizziness or blurring of vision. Use caution while driving or performing
tasks requiring alertness.
2.Avoid alcohol and other CNS depressants.
3.Notify physician if nausea,vomiting or constipation become prominent.
4.If GI uo\pset occurs,these agents may be taken with food.
5.Notify physician,if shortness of breath or difficulty of breathing occurs.
Pharmacology/ Pharmacokinetics:
- REFER DEXTROPROPOXYPHENE
Interaction with Food:
Not reported
Pregnancy and lactation:
Pregnancy:
Safety for use during pregnancy has not been established. Use with extreme caution.
Lactation:
These agent appear in breast milk. use with exteme caution.
