Addiction to Percocet - Essay Example

? Addiction to Percocet Addiction to Percocet Introduction This paper provides an overview of an addictive painkiller Percocet that is widely used in the U.S. medical practice to relieve sever pain. It explores potential effects and precautions of Percocet prescription and use in the nursing practice with focus on pregnant women and Percocet’s impact on a fetus. A brief overview of the substance is followed by the sections on the nursing care considerations during the drug user’s pregnancy in general and during the second trimester in particular, and for the neonate. In addition, the paper explores the potential solutions to the issues that may arise during Percocet use in patient treatment. It ends with a conclusion that summarizes the overall discussion of Percocet: its effects and warnings. 2. Overview of Substance 2.1. What is Percocet? Medications that treat pain are known to have been the first line of defense directed against pain and a standard prescription practice across the United States for decades (Cole, 2012). While they are believed to considerably raise patient quality of life, narcotics often lead to addiction and, if overdosed, to death. Percocet, an opiate-based drug, is one of such painkillers. It relieves severe pain, but puts a person at risk of becoming an addict. To make the matters worse, once consumed in a non-prescribed or excessive manner, Percocet may lead to fatal consequences. Needless to say, withdrawal from addiction is very painful and accompanied by a range of symptoms including muscle pain, anxiety, panic, muscle weakness, fever, insomnia, and nausea, etc (CESAR, n.d.). 1.2. Percocet Ingredients. Percocet is a trade name of oxycodone and comes in a tablet form. Other brand names of oxycodone, along with Percocet, are OxyContin, Percodan, Endodan, Roxicet, Roxiprin, Endocet, Tylox, Magnacet, Primlev, Xolox. Defined as “ a semi-synthetic opiate manufactured by modifying the chemical thebaine, an organic chemical found in opium”, oxycodone is known to be as powerful, dangerous, and addictive as heroin (CESAR, n.d., Drug-Free World Foundation, 2008). Oxycodone is classified as a Schedule II drug, which means that it has a high potential for being abused. It also means that the medication is currently accepted (with restrictions) in the United States, and may lead to severe dependence, either psychological or physical (Office of Diversion Control, 2013). In terms of active ingredients, Percocet also contains acetaminophen along with oxycodone, which increases the pain relieving effect. 2.3. Percocet: Side Effects & Consequences of Use. On 30 June 2009, Percocet was recommended to be removed from the U.S. market by an FDA advisory panel. Along with another drug, Paracetamol, Percocet was accountable for more than 400 deaths over one year. That was caused by the fact that the overdose of these drugs or their intake along with multiple other drugs can cause death (Hombach, 2012, p.122). The consequences and side effects of Percocet are grievous and numerous. An overdose of Percocet is likely to cause death. Oxycodone overdose may lead to circulatory collapse, cardiac arrest, apnea, and death. Overdose of acetaminophen leads to the fatal condition of hepatitis necrosis, hypoglycemic coma, renal tubular necrosis, and thrombocytopenia. Evidently, a combination of two, found in Percocet, means a double effect when overdosed. Percocet is a highly addictive drug. Prolonged use of the drug leads to addiction, when the user’s brain is charged in such manner that he or she is not capable of quitting on their own. Once the user decides to quit, withdrawal symptoms appear to be high, in particular if the withdrawal is sudden. The symptoms of withdrawal are severe and include: anxiety, insomnia, nausea, muscle pain, fevers, and a range of other flu-like symptoms (CESAR, n.d.). A number of side effects that result from Percocet use include respiratory depression, irregularity of breathing, nausea, growing pressure of spinal/cerebral fluid, seizures, headaches, heart/liver failure, dizziness, and low blood pressure. When taking this narcotic, it is prohibited to use any alcoholic leverages, drive, and engage in some activities that require being energetic. Besides, the drug contains allergic ingredients (California Physician, 1995, p.xxiv). With a number of side effects and serious warnings against Percocet prolonged use and overdose, it is recommended that pregnant users consult their physician about the necessity of Percocet prescription. In the next section, the nursing care considerations related to Percocet use during pregnancy are discussed. 3. Percocet Use during Pregnancy 3.1. Percocet Prescription for Pregnant Users. It is vital that pregnant women do not use Percocet unless clearly needed. While little research has been carried out on Percocet use by pregnant women, the very fact that Percocet is a narcotic, with all its side-effects and addiction potential makes it quite dangerous (Little, 2006). Before prescribing a drug, one has to ensure the patient’s medical history allows it, and the dosage has been selected adequately. Once the patient is known to have had brain disorders (for example, seizures, tumor, or head injury), liver disease, breathing problems (for example, asthma, chronic obstructive pulmonary disease or COPD, and sleep apnea), kidney disease, a personal history (or even a family history) of alcohol/drug addiction or abuse, mental disorders, mood disorders, intestinal problems, stomach problems, or finds it difficult to urinate, the use of the drug has to be carefully considered and the dosage has to be adjusted. Once prescribed, the use of the drug should be monitored. 3.2. Nursing Care of Pregnant Users of Percocet. As far as no clinical research has been done into the consequences of Percocet use by pregnant women, nursing specialists should be vigilant and careful when taking care of pregnant users of Percocet. Pre-administration assessment should be done in the most accurate manner. The nurse has to assess the pulse, BP, and patient’s respirations both prior to and during Percocet administration. Level of sedation should also be assessed and controlled. The nurse should asses the type of pain, intensity of pain, and its location before and 1 hour after (the peak) the drug administration. The bowl function should be assessed, too (Spratto & Woods, 2012). The nurse should ask herself/himself a question why this medication would not be given. These are respiratory rate less than 10, tachycardia, and the patient’s increased BP. As matter of fact, pregnancy makes the patient hypersensitive and may serve as a serious contraindication for this drug to be used (Spratto & Woods, 2012, p. 1310-1311). Once the drug is prescribed, the women should be taught about how to take the medication and get instructed about its side effects. For instance, Percocet may be a cause of the patient’s drowsiness as well as dizziness. In addition, the use of any other CNS depressants should be avoided. After giving the medication, the nurse should check the effects of the drug in the patient. Decrease in pain should go without any considerable alterations in her level of consciousness or general respiratory status. 3.3. Warnings against Percocet Use. The nursing specialist should keep it in mind that Percocet evokes dependence, both psychological and physical. Namely, the feeling of euphoria that patients experience sometimes may cause them to increase the dosage of the drug. Therefore, the use of Percocet should be strictly supervised (Spratto & Woods, 2012). The warning also goes against the use of this drug during the first two months of pregnancy. This may increase the risk of birth defects. 4. Care Considerations during the Second Trimester 4.1. Perceived Impact of Percocet during the Second Trimester During the second trimester of pregnancy, the nurse should be aware of the possible harm that Percocet may inflict in a fetus. Since there have been no standardized studies on the issue, medical specialists keep prescribing the drug based on the common knowledge that no severe effects, i.e. birth defects, have been noticed so far in newborns. Medical specialists are also guided by the information on animal studies that explored the effects on pregnant animals of the Percocet’s separate components: oxycodone and acetaminophen. The latter is believed to be quite safe, while the former is known not to account for any birth defects or similar problems in babies. 4.2. Dangers of Prolonged Use However, the prolonged use of this narcotic clearly leads to the woman’s possible addiction and refusal to stop using it in the third trimester. This is dangerous for the baby, because newborns are likely to experience withdrawal symptoms and may suffer from fatal consequences in case of prolonged use (Ganda, 2013). Thus, the use of the drug should be carefully prescribed and, if possible restricted, during the second trimester, to the severe cases of pain. 4.3. Prescription Considerations. Provided the drug refers to the Category C (i.e. it has not been researched in pregnant humans in an adequate way, but may cause harm), the decision of its use should be motivated by understanding that possible danger is outweighed by the expected benefits. The decision should be enhanced by awareness that the prolonged use of the medication may convert it into a category D drug which causes serious breathing difficulty in newborns or even their death (Ganda, 2013, p.89). 5. Care Considerations for the Neonate 5.1. Neonate’s Conditions as a Result of Percocet Use The major considerations related to neonate care are those of withdrawal symptoms in newborns. If the drug use has not been gradually stopped before the birth, the baby will suffer from the following conditions: excessive crying, tremors or shakiness, fever, irritability, fast breathing, sneezing, slow or shallow breathing, diarrhea, yawning, persistent and abnormal crying, vomiting, restlessness, and having difficulty sleeping. 5.2. Respiratory Depression in Neonates. Besides, a drug-dependent fetus and a newborn may experience a respiratory depression, so Percocet is forbidden to be used immediately before labor and baby delivery. This is caused by the fact that the medication remains in the neonate’s bloodstream after the birth as a result of Percocet’s passing through the mother’s placenta into the bloodstream of a foetus (Spratto & Woods, 2012). 5.3. Mother’s Impact on Neonate. The neonate will also be affected by the mother’s condition, since mothers are also affected by withdrawals. This is a result of a sharp drop in Percocet use. In addition, breastfeeding by this mother may lead to the baby’s unusual sleepiness, having difficulty feeding, and trouble breathing. 6. Addressing the Issue 6.1. Warnings to Consider Nursing specialists should consider all warnings and precautions against the use of Percocet in pregnant women. Categorized as C (and D in cases of its prolonged use), this drug is potentially dangerous for the fetus. Only when the potential benefits do outweigh the potential harm should this drug be prescribed to pregnant women. 6.2. Implications for Prescription. In the first two months of pregnancy, the drug is not recommended for prescription and use. In the second trimester, its intake should be controlled so that dosage does not increase but gradually decreases. Before the baby is born, the intake should have already been stopped. 6.3. Preventing Addiction in Pregnant Users. Pregnant women’s condition should be regularly assessed and monitored. Mothers-to-be should be instructed about the specifics of the Percocet use and its dangers. Nurses should make every effort to prevent addiction in pregnant women and control Percocet intake and effects. 7. Conclusion In summary, Percocet is a powerful painkiller produced as a combination of two potent substances: oxycodone and acetaminophen. It relieves severe pain in patients, but may lead to addiction as a result of the prolonged use. Its overdose is likely to lead to death or fatal conditions like heart or liver failures. With a number of warnings and precautions to consider, this drug is prescribed to pregnant women in the United States. Nursing specialists should conduct careful assessments of the patient’s condition, nature of pain, the patient’s reaction to the drug, examine the medical and family history of the patient, and regularly monitor the narcotic intake. The use before labor and in the first two months should be avoided. The prolonged use should be avoided. In neonatal care, the nurse should be prepared to deal with withdrawal symptoms in babies and mothers. References California Medical Association (1995). California Physician , Vol. 12. California Medical Association. CESAR (N.d.) “Oxycodone.” Center for Substance Abuse Research. Retrieved on July 18, 2013 from http://www.cesar.umd.edu/cesar/drugs/oxycodone.asp. Cole, D. (2012). Pain management solutions: managing pain in stages.iUniverse. Drug-Free World Foundation (2008). The truth about painkillers. Foundation for a Drug-Free World. FDA Office of Diversion Control (2013). “Section 1308.12 Schedule II.” Retrieved on July 18, 2013from http://www.deadiversion.usdoj.gov/21cfr/cfr/1308/1308_12.htm. Hombach, J.-P. (2012). Elvis Presley: The king of rock 'n'roll. Hombach. Ganda, K. (2013). Dentist’s guide to medical conditions, medications, and complications. John Wiley & Sons. Spratto, G. & Woods, A. (2012). Delmar nurse’s drug handbook . Cengage Learning. Read More