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Darvon

Dextropropoxyphene is an analgesic in the opioid category. It is used to treat mild to moderate pain and as an antitussive. It can be used to ease pain before, during and after an operation. It is often combined with acetominophen in the preparation co-proxamol(Darvocet in the US). more...

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It is an optical isomer of Levopropoxyphene. The racemic mixture is called Propoxyphene.

Some preparations that contain dextropoxyphene include: Distalgesic and Doloxene.

The therapeutic index of dextropoxyphene is relatively small. In the UK, dextropoxyphene and co-proxamol are now discouraged from general use. Since 2004 preparations containing only dextropropoxyphene have been discontinued.

In the United States, dextropropoxyphene HCl is available as a prescription with acetaminophen in ratio anywhere from 30mg / 600mg to 60mg / 325mg, respectively. These are usually named "Darvocet," "Darvin," or "Darvon." Dextropropoxyphene is subject to some controversy: while many physicians prescribe it for a wide range of mildly to moderately painful symptoms as well as in treatment of diarrhoea, many others refuse to prescribe it, citing its highly addictive nature and limited effectiveness (some studies show it to be no more effective as a painkiller than aspirin).

Darvocet overdose is commonly broken into two categories: acetaminophen toxicity and dextropropoxyphene overdose. Many users experience toxic effects from the acetaminophen in pursuit of the endlessly-increasing dose required to achieve euphoria. They suffer acute liver toxicity, which causes severe stomach pain, nausea, and vomiting (all of which are increased by light or stimulation of the sense of sight).

Other users experience longer-term problems from consistent use of abusively high dextropropoxyphene levels. They take anywhere from 240 to 420 milligrams of dextropropoxyphene (and the acetaminophen that goes with it) in search of an increasingly elusive feeling of euphoria. These users often suffer a constantly dry mouth, decreased appetite, urinary retention and constipation. Because tolerance to dextropropoxyphene increases so quickly and because of its strong constipating effects, many people suffer a gruesome and painful rupture in the colon.

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Clinical quiz
From American Family Physician, 3/1/05

Clinical is for one year Quiz questions are based on selected articles in this issue of American Family Physician. Answers appear in this issue. AFP has been reviewed by the American Academy of Family Physicians as having content acceptable for Prescribed credit. Term of approval from the beginning distribution date of March 1, 2005. This issue has been reviewed and is acceptable for up to 4 Prescribed credits. One and one quarter credits conform to AAFP criteria for evidence-based continuing medical education (EB CME) clinical content. The amount of CME has been doubled to reflect two-for-one credit for the EB CME portion only. When reporting CME credits, AAFP members should report total Prescribed credits earned for this activity. It is not necessary for members to label credits as EB CME for reporting purposes.

The AAFP is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide CME for physicians.

The AAFP designates this educational activity for a maximum of 4 Category 1 credits toward the American Medical Association Physician's Recognition Award (AMA/PRA). Each physician should claim only those credits that he or she actually spent in the activity.

AAFP Credit

Each copy of AFP contains a Clinical Quiz answer card. AAFP members may use this card to obtain the designated number of Prescribed credit hours for the year in which the card is postmarked.

AMA/PRA Category 1 Credit

AAFP members who satisfy the Academy's CME requirements are automati-cally eligible for the AMA/PRA.

Physicians who are not members of the AAFP are eligible to receive the designated number of credits in Category 1 of the AMA/PRA on completion and return of the Clinical Quiz answer card. AFP keeps a record of AMA/PRA Category 1 credits for nonmember physicians. This record will be provided on request; however, nonmembers are responsible for reporting their own Category 1 CME credits when applying for the AMA/PRA or other certificates or credentials.

For health care professionals who are not physicians and are AFP sub-scribers, a record of CME credit is kept by AAFP and will be provided to you on written request. You are responsible for reporting CME credits to your professional organization.

NOTE: The full text of AFP is available online (http://www.aafp.org/afp), including each issue's Clinical Quiz. The table of contents for each online issue will link you to the Clinical Quiz. Follow the online directions to take the quiz and, if you're an AAFP member, you can submit your answers for CME credit.

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