This page was prepared by Tami Skinner, LPN Internet Nursing Guide
Michigan Nurses, Pediatrics, Respiratory, Home Health, Medical-Surgical, Long Term Care
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Talwin, Talwin NX(Pentazocine)Pharmacokinetics and contraindications: 48 hours: "Absorption: readily absorbed from GI tract; 20% reaches systemic circulation (first pass metabolism). Onset: 15–30 min PO, IM, SC; 2–3 min IV. Peak: 1–3 h PO, IM; 15 min IV. Duration: 3 h PO, IM; 1 h IV. Distribution: crosses placenta. Metabolism: extensively metabolized in liver. Elimination: half-life: 2–3 h; excreted primarily in urine; small amount in feces.Contraindicated in: head injury, increased intracranial pressure; emotionally unstable patients, or history of drug abuse. Safe use during pregnancy (other than labor) (category C) and in children 12 y not established. Cautious use in: impaired renal or hepatic function; respiratory depression; biliary surgery; patients with MI who have nausea and vomiting."
http://www.48hours.net/plweb-cgi/fastweb.exe?getdoc+Guide+Guide+812+0+++PENTAZOCINE+adj+HYDROCHLORIDE%3ADRUGNAME

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Talwin (Pentazocine) description and comprehensive drug information:Rx List: "TALWIN Nx contains pentazocine hydrochloride, USP, equivalent to 50 mg base and is a member of the benzazocine series (also known as the benzomorphan series), and naloxone hydrochloride, USP, equivalent to 0.5 mg base. TALWIN Nx is an analgesic for oral administration. Chemically, pentazocine hydrochloride is 1, 2, 3, 4,5,6-Hexahydro- 6,11-dimethyl-3-(3- methyl-2-butenyl)-2,6-methano-3-benzazocin-8- ol hydrochloride, a white, crystalline substance soluble in acidic aqueous solutions.Chemically, naloxone hydrochloride is Morphinan-6-one, 4, 5-epoxy-3, 14-dihydroxy-17- (2-propenyl)-, hydrochloride, (5a). It is a slightly off-white powder, and is soluble in water and dilute acids. Inactive Ingredients: Colloidal Silicon Dioxide, Dibasic Calcium Phosphate, D&C Yellow #10, FD&C Yellow #6, Magnesium Stearate, Microcrystalline Cellulose, Sodium Lauryl Sulfate, Starch."
http://arthritis.about.com/gi/dynamic/offsite.htm?site=http%3A%2F%2Fwww.rxlist.com%2Fcgi%2Fgeneric%2Fpentazocine.htm

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NURSING IMPLICATIONS for patients taking Talwin (Pentazocine): Harcourt Health: "BASELINE ASSESSMENT: Raise bed rails. Obtain vital signs before giving medication. If respirations are 12/min or lower, withhold medication, contact physician. Assess onset, type, location, and duration of pain. Effect of medication is reduced if full pain recurs before next dose. INTERVENTIONS/EVALUATION: Encourage deep breathing and coughing exercises. Check vital signs periodically (5-10 min after IV dose). Monitor for change in respirations, B/P, change in rate/quality of pulse. Initiate deep breathing and coughing exercises, particularly in those with impaired pulmonary function. Change pt's position q2-4h. Assess for clinical improvement and record onset of relief of pain. Contact physician if pain is not adequately relieved. PATIENT/FAMILY TEACHING: Change positions slowly to avoid dizziness. Head-low position may help relieve lightheadedness, nausea. Explain need for assistance if ambulating. Avoid alcohol. Request pain medication before pain fully recurs."
http://www.harcourthealth.com/SIMON/SaundersNDH/update_trade_frame.html

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Available forms of Talwin (Pentazocine): University of Iowa Nursing: "Talacen (Pentazocine HCL 25 mg with acetaminophen 650 mg) Talwin Nx (Pentazocine HCL 50 mg with Naloxone 5 mg) Talwin Compound (Pentazocine HCL 12.5 mg with aspirin 325 mg) Talwin (Pentazocine lactate 30 mg) The form you are taking is written on the label of your prescription. If you are unsure of the form you have, call your nurse, pharmacist or doctor.TELL your doctor, nurse, and pharmacist if you:have allergies. are pregnant or plan to become pregnant. are breast-feeding. are taking ANY other medicine, including those you buy yourself such as aspirin or cold medicine. Taking other medicine that contains acetaminophen or a narcotic while you are taking this medicine may lead to overdose. have ANY other medical problems. Talwin in all forms is a prescription drug.Route: Talacen, Talwin Nx, and Talwin Compound are taken by mouth.Talwin (Pentazocine lactate) is taken as a shot. Use: For mild to severe pain."
http://www.nursing.uiowa.edu/sites/adultpain/MixedAge/Talwinnt.htm

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Clinical Pharmacology of Talwin (Pentazocine): CTCL Consult: "Pentazocine is a potent analgesic which when administered orally in a 50 mg dose appears equivalent in analgesic effect to 60 mg (1 grain) of codeine. Onset of significant analgesia usually occurs between 15 and 30 minutes after oral administration, and duration of action is usually three hours or longer. Onset and duration of action and the degree of pain relief are related both to dose and the severity of pretreatment pain. Pentazocine weakly antagonizes the analgesic effects of morphine and meperidine; in addition, it produces incomplete reversal of cardiovascular, respiratory, and behavioral depression induced by morphine and meperidine. Pentazocine has about 1/50 the antagonistic activity of nalorphine. It also has sedative activity.Pentazocine is well absorbed from the gastrointestinal tract. Concentrations in plasma coincide closely with the onset, duration, and intensity of analgesia; peak values occur 1 to 3 hours after oral administration. The half-life in plasma is 2 to 3 hours.Pentazocine is metabolized in the liver and excreted primarily in the urine. Pentazocine passes into the fetal circulation.Naloxone when administered orally at 0.5 mg has no pharmacologic activity. Naloxone hydrochloride administered parenterally at the same dose is an effective antagonist to pentazocine and a pure antagonist to narcotic analgesics."
http://www.ctclconsult.com/pdrdruginfo/html/73003900.htm

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Talwin (Pentazoncine) Contraindicated in some patients: A Healthy Me: "Naloxone and pentazocine is habit forming. If you have an alcohol or drug addiction, this medication should only be used only under close medical supervision. Before taking this medication, tell your doctor if you have kidney disease; liver disease; asthma; urinary retention; an enlarged prostate; hypothyroidism; seizures or epilepsy; gallbladder disease; a head injury; or Addison's disease.You may not be able to take naloxone and pentazocine, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.Naloxone and pentazocine is in the FDA pregnancy category C. This means that it is not known whether naloxone and pentazocine will harm an unborn baby. Naloxone and pentazocine may cause addiction and withdrawal symptoms in an unborn baby. Do not take naloxone and pentazocine without first talking to your doctor if you are pregnant. It is not known whether naloxone and pentazocine passes into breast milk. This medication may cause addiction and withdrawal symptoms in a nursing infant."
http://www.ahealthyme.com/topic/topic100592164

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