Image:Perphenazine chemical structure.png
Find information on thousands of medical conditions and prescription drugs.

Trilafon

Home
Diseases
Medicines
A
B
C
D
E
F
G
H
I
J
K
L
M
N
O
P
Q
R
S
T
Oxytetracycline
Phentermine
Tacrine
Tacrolimus
Tagamet
Talbutal
Talohexal
Talwin
Tambocor
Tamiflu
Tamoxifen
Tamsulosin
Tao
Tarka
Taurine
Taxol
Taxotere
Tazarotene
Tazobactam
Tazorac
Tegretol
Teicoplanin
Telmisartan
Temazepam
Temocillin
Temodar
Temodar
Temozolomide
Tenex
Teniposide
Tenoretic
Tenormin
Tenuate
Terazosin
Terbinafine
Terbutaline
Terconazole
Terfenadine
Teriparatide
Terlipressin
Tessalon
Testosterone
Tetrabenazine
Tetracaine
Tetracycline
Tetramethrin
Thalidomide
Theo-24
Theobid
Theochron
Theoclear
Theolair
Theophyl
Theophyl
Theostat 80
Theovent
Thiamine
Thiomersal
Thiopental sodium
Thioridazine
Thorazine
Thyroglobulin
Tiagabine
Tianeptine
Tiazac
Ticarcillin
Ticlopidine
Tikosyn
Tiletamine
Timolol
Timoptic
Tinidazole
Tioconazole
Tirapazamine
Tizanidine
TobraDex
Tobramycin
Tofranil
Tolazamide
Tolazoline
Tolbutamide
Tolcapone
Tolnaftate
Tolterodine
Tomoxetine
Topamax
Topicort
Topiramate
Tora
Toradol
Toremifene
Tracleer
Tramadol
Trandate
Tranexamic acid
Tranxene
Tranylcypromine
Trastuzumab
Trazodone
Trenbolone
Trental
Trest
Tretinoin
Triacetin
Triad
Triamcinolone
Triamcinolone hexacetonide
Triamterene
Triazolam
Triclabendazole
Triclosan
Tricor
Trifluoperazine
Trilafon
Trileptal
Trimetazidine
Trimethoprim
Trimipramine
Trimox
Triprolidine
Triptorelin
Tritec
Trizivir
Troglitazone
Tromantadine
Trovafloxacin
Tubocurarine chloride
Tussionex
Tylenol
Tyrosine
U
V
W
X
Y
Z

Read more at Wikipedia.org


[List your site here Free!]


Adverse effects of opioid therapy
From Rehabilitation Oncology, 1/1/99 by McKee, Alfred L Jr

CONSTIPATION

Define constipation as no b.m. in 24 hours, constipation does not improve with continued opioid analgesic treatment

RX:

2 senna + docusate Tabs (e.g. Senokot S) po q.hs Senna is available as a tea. If no relief in 24 - 48hrs:

Increase:senna on bid basis

Add:bisacodyl (Dulcolax) 2 - 3 tabs po q.hs (range: I tab q.hs to 3 tabs t.i.d) Metoclopramide (Reglan) 10mg to 20mg po q.i.d or 10mg to 20mg po q.i.d Cisapride (Propulsid) 10mg to 20mg po, q.i.d (with cisapride watch for drug interaction). May be used in addition to senna or in some patients instead of senna.

Persistent Constipation

If no relief in 2 - 3 days

non-impacted.

Magnesium citrate 8oz po

Buffered saline oral solution

(Fleet Phospho-Soda)

Mineral Oil

Bisacodyl (Dulcolax) suppository I pr

Lactulose 45 - 60cc po q.2hrs'till b.m.(lactulose will often cause

abdominal cramps and flatulence

Buffered saline enema (Fleet Phospho-Soda) Enema I pr if rectal exam reveals stool impacted.

Disimpact Enemas until clear

Increase daily senna and bisacodyl

For resistant constipation may try metoclopramide infusion (I I mg/kg) over 2 - 4 hours

NAUSEA

Nausea is very common with the use of opioid analgesics and may be dose dependent

RX:

Relieve constipation

Andernetics

If there is a vestibular component, meclizine(Antivert) 12.5mg

25mg po q.i.d or scopolamine may be effective.

Metoclopramide (Reglan): Has po & IV forms

Prochlorperazine (Compazine): Has po, suppository & IV forms

Thiethylperazine (Torecan): Has po form

Perphenazine (Trilafon): Has po (tablet & liquid) & IV forms

Cisapride (Propulsid): Has po form

Haloperidol (Haidol): Has po & IM forms

Droperidol (inapsine): Has IV form

Occasionally one may see benefit with trimethobenzamide

(Tigan) and hydroxyzine (Atarax and Vistaril)

With frequent use of antiernetics monitor for extrapyramidal symptoms- may give low doses of diphenhydramine (Benadryl) avoid in AIDS Dementia (try amantadine).

URINARY HESITANCY/RETENTION

Urinary hesitancy or retention is fairly common.

RX:

Often terazosin (Hytrin) at 1-3mg q.hs ameliorates this. For men, may also use tarnsulosin (Flomax).4mg I qd, Y2hourpc

SEDATION

Start with a careful interview concerning sleep including questions about induction, awakening, total hours of sleep, whether the patient is refreshed upon awakening, snoring, and partner reports of apnea Evaluate other centrally acting medications

RX:

Caffeinated beverages

Caffeine tablets

Methylphenidate (Ritalin) 10-40mg po q.am and 5 - 40mg po q.noon (may use up to 1.5mg/kg q.d)

Dextroamphetamine (Dexadrine) 5-20mg p.o. q.am and 5-20mg po q.noon

Pemoline (Cylert) 18.75mg, 1-5 tabs q.am

- periodically check liver function tests

SEXUAL DYSFUNCTION

Inquire about altered libido, sexual function low, testosterone in both men and women is common.

Testosterone replacement is often effective for men, check peak and trough testosterone levels.

RX:

For men, the usual replacement dose is 200mg of testosterone enanthate

IM q.2weeks and for women the usual dose is 15mg IM q.2weeks After establishing normal range testosterone levels in men, erectile problems may persist.

Try sildenafil (Viagra) 50mg, 1/2 - 2 hours q.pre-relations. Ejaculatory dysfunction may be related to the timing of short acting opioid dose.

DELIRIUM

Delirium does not develop with opioids at steady state/stable dosing unless there is a change in clearance of opioid metabolites. Delirium commonly occurs in the setting of opioid analgesics When infection develops, a CNS event has occurred or another CNS active medication has been added.

RX:

Delirium related to opioids is an indication for hydration or opioid rotation as are myoclonic jerks and seizures

SWEATING

Diaphoresis/Sweating is common

RX:

May use glycopyfflate (Robinul) I mg 1-3 qhs or hyosMwiine (Levsin) 125mg 1-2 q.id.

PRURITIS

Pruritis is common and may be dose dependent

RX:

Pruritis may improve with diphenhydramine (Benadryl) or cimetidine /ranitidine/famotidine

JOINT PAIN

Joint pain, espec

RX:

This may resolve with time, may be opioid specific, and may respond to antiinflammatory agents

EDEMA/MYOSITIS

Lower extremity edema may occur with aggressive dosing of opioids - especially with oxycodone. Myositis is dose dependent and has developed when doxepin and citalopram have been added to stable doses of opioids. With or without pain, lower extremity edema with opioids may be caused by myositis, check CPK

RX:

If myositis is present based on clinical exam and/or lab studies, rotate opioids or d/c new agent

Alfred L. McKee, Jr, MD Staff Oncologist, Baystate Medical Center Assistant Professor Medicine Tufts University School of Medicine Boston, Massachusetts

Copyright Rehabilitation in Oncology 1999
Provided by ProQuest Information and Learning Company. All rights Reserved

Return to Trilafon
Home Contact Resources Exchange Links ebay