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Pronunciation

METH-a-done

Classifications

Therapeutic Classification: opioid analgesics

Pharmacologic Classification: opioid agonists

Indications

High Alert


Unlabeled Use:
  • Neonatal abstinence syndrome.

Action

  • Binds to opiate receptors in the CNS.
  • Alters the perception of and response to painful stimuli while producing generalized CNS depression.
Therapeutic effects:
  • Decrease in severity of pain.
  • Suppression of withdrawal symptoms during detoxification and maintenance from heroin and other opioids.

Pharmacokinetics

Absorption: 50% absorbed following oral administration. IV administration results in complete bioavailability.

Distribution: Widely distributed to tissues.

Protein Binding: 85–90%.

Metabolism/Excretion: Mostly metabolized by the liver; some metabolites are active and may accumulate with chronic administration. Primarily excreted in the urine (<10% as unchanged drug).

Half-Life: 15–25 hr ( with chronic use).

Time/Action Profile

(analgesic effect)

ROUTEONSETPEAKDURATION
PO30–60 min90–120 min4–12 hr
IM, IV, SUBQ10–20 min60–120 min8–12 hr



Contraind./Precautions

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects

CV: hypotension, bradycardia, QT interval prolongation, TORSADES DE POINTES

Derm: flushing, sweating

EENT: blurred vision, diplopia, miosis

Endo: adrenal insufficiency

GI: constipation, nausea, vomiting

GU: urinary retention

Neuro: confusion, sedation, dizziness, dysphoria, euphoria, floating feeling, hallucinations, 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

Moderate to Severe Pain

Opioid Detoxification

Availability

(Generic available)

Assessment

Lab Test Considerations:

Toxicity and Overdose:

Implementation

IV Administration:

Patient/Family Teaching

Evaluation/Desired Outcomes

US Brand Names

Dolophine, Methadose

Canadian Brand Names

Metadol, Metadol-D

Contr. Subst. Schedule

Schedule II (C-II)

Code

NDC Code