section name header

Pronunciation

byoo-TOR-fa-nole

Classifications

Therapeutic Classification: opioid analgesics

Pharmacologic Classification: opioid agonists antagonists

Indications

High Alert


Action

  • Binds to opiate receptors in the CNS.
  • Alters the perception of and response to painful stimuli while producing generalized CNS depression.
  • Has partial antagonist properties that may result in opioid withdrawal in physically dependent patients.
Therapeutic effects:
  • Decreased severity of pain.

Pharmacokinetics

Absorption: Well absorbed from IM sites and nasal mucosa.

Distribution: Extensively distributed to tissues.

Metabolism/Excretion: Mostly metabolized by the liver; 11–14% excreted in the feces. Minimal renal excretion.

Half-Life: 3–4 hr.

Time/Action Profile

(analgesia)

ROUTEONSETPEAKDURATION
IMwithin 15 min30–60 min3–4 hr
IVwithin min4–5 min2–4 hr
Intranasalwithin 15 min1–2 hr4–5 hr





Contraind./Precautions

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects

CV: hypertension, hypotension, palpitations

Derm: sweating, clammy feeling

EENT: blurred vision, diplopia, miosis (high doses)

GI: nausea, constipation, dry mouth, ileus, vomiting

GU: urinary retention

Neuro: confusion, dysphoria, hallucinations, sedation, euphoria, floating feeling, headache, unusual dreams

Resp: RESPIRATORY DEPRESSION (INCLUDING CENTRAL SLEEP APNEA AND SLEEP-RELATED HYPOXEMIA)

Misc: allodynia, opioid-induced hyperalgesia, physical dependence, psychological dependence, tolerance

Interactions

Drug-drug:

Drug-Natural Products:

Route/Dosage

Availability

(Generic available)

Assessment

Lab Test Considerations:

Toxicity and Overdose:

Implementation

IV Administration:

Patient/Family Teaching

Evaluation/Desired Outcomes

US Brand Names

Stadol

Contr. Subst. Schedule

Schedule IV (C-IV)