butorphanol (Stadol, Stadol NS)
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Introduction
Tradename: Stadol.
Indications
- treatment of moderate to severe pain
- sedation in conjunction with anesthesia, general anesthesia[4]
Contraindications
Caution:
- avoid use in opiate dependent patient may precipitate opiate withdrawal
- use with caution in patients with hepatic or renal impairment
Dosage
Injection: 1 mg/mL (1 mL), 2 mg/mL (1, 2, 10 mL).
Nasal spray: Tradename: Stadol NS. 1 spray every 3-4 hours. 1 mg/spray.
Pharmacokinetics
elimination via liver
Adverse effects
- common (> 10%)
- less common (1-10%)
- increased sweating, flushing of the face, decreased urination, dizziness, lightheadedness, headache, hypotension, anorexia, nausea/vomiting
- uncommon (< 1%)
- skin rash, shortness of breath, troubled breathing, paradoxical CNS stimulation, confusion, bradycardia, tachycardia, hallucinations, painful urination, hypertension, mental depression, stomach cramps, tinnitus, blurred vision, constipation, dry mouth, false sense of well being, malaise, restlessness, nightmares, weakness, CNS depression, respiratory depression, dependence with prolonged use
- other
- may elevate CSF pressure
- may increase cardiac workload
- support airway
- establish IV access
- naloxone 2 mg IV (0.1 mg/kg for children)
- repeat naloxone as necessary up to 10 mg
- drug adverse effects of opiates
- drug adverse effects of psychotropic agents
- drug adverse effects of sedatives
Drug interactions
- drug interaction(s) of benzodiazepine with opiates
- drug interaction(s) of Z-drugs with opiates
- drug interaction(s) of alcoholic beverage with opiates
- drug interaction(s) of pregabalin with opiates
- drug interaction(s) of gabapentin with opiates