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Butorphanol (Stadol) Nursing Considerations

Butorphanol (Stadol) Nursing Considerations

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Outline

Generic Name

butorphanol

Trade Name

Stadol

Indication

moderate to severe pain, labor pain, sedation

Action

alters perception and response to pain by binding to opiate receptors in CNS

Therapeutic Class

Opioid Analgesic

Pharmacologic Class

opioid agonists/antagonists

Nursing Considerations

• use caution with concurrent use of MAOIs
• may cause confusion, hallucinations, sedation
• monitor for CNS depression
• assess blood pressure pulse and respirations during administration
• administer slowly through an IV line

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Transcript

Hi guys, let’s talk about butorphanol, also known as Stadol. This is an IV medication, as you can see here in the picture, and it also comes as a nasal spray. So remember when we talk, talk about the therapeutic class versus the pharmacologic class, the therapeutic class is what the drug does in the body while the pharmacologic class is its actual chemical effect. So the therapeutic class of butorphanol is it is an opioid analgesic and the pharmacologic class is an opioid agonist-antagonist. So let’s talk about the mechanism of action of butorphanol. It works by altering the perception in response to pain, by binding to opiate receptors in the central nervous system. Butorphanol is indicated for moderate to severe severe pain, labor, and sedation.

So some side effects that can be seen with butorphanol are confusion, sedation, and even hallucinations. So let’s take a look at some nursing considerations with butorphanol. Of course, you are going to want to monitor for any hypotension, respiratory depression, and bradycardia, as these could indicate an overdose, and you will do this by assessing blood pressure and respirations during therapy. And when you administer, you must administer it slowly through the IV because it really does slow breathing there. Cross-reactivity with other opioids like hydrocodone, codeine, hydromorphone, and oxycodone. Caution must be taken with butorphanol when the patient is also on MAOIs and teach the patient to report any side effects and to always take as directed. So guys, I know we probably hear about patients overdosing on medications other than butorphanol or Stadol, but I have had a patient come into the ICU for a Stadol overdose as this medication can create tolerance and dependence like other opioids. So that is it for butorphanol or Stadol. Now go out and be your best self and as always happy nursing.

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Pharmacology

Concepts Covered:

Study Plan Lessons

Pharmacology Course Introduction

12 Points to Answering Pharmacology Questions

54 Common Medication Prefixes and Suffixes

Therapeutic Drug Levels (Digoxin, Lithium, Theophylline, Phenytoin)

Essential NCLEX Meds by Class

6 Rights of Medication Administration

Pharmacodynamics

Pharmacokinetics

The SOCK Method – Overview

The SOCK Method – S

The SOCK Method – O

The SOCK Method – C

The SOCK Method – K

Basics of Calculations

Oral Medications

Injectable Medications

IV Infusions (Solutions)

Complex Calculations (Dosage Calculations/Med Math)

Interactive Pharmacology Practice

Interactive Practice Drip Calculations

Pediatric Dosage Calculations

Disease Specific Medications

Antianxiety Meds

Benzodiazepines

ACLS (Advanced cardiac life support) Drugs

Anti-Platelet Aggregate

NG Tube Medication Administration

Thrombin Inhibitors

Anticonvulsants

Antidepressants

Antidiabetic Agents

Insulin – Mixtures (70/30)

Histamine 1 Receptor Blockers

Histamine 2 Receptor Blockers

Renin Angiotensin Aldosterone System

Sympatholytics (Alpha & Beta Blockers)

ACE (angiotensin-converting enzyme) Inhibitors

Angiotensin Receptor Blockers

Calcium Channel Blockers

Cardiac Glycosides

Anti-Infective – Aminoglycosides

Anti-Infective – Antifungals

Anti-Infective – Antitubercular

Anti-Infective – Antivirals

Anti-Infective – Carbapenems

Anti-Infective – Fluoroquinolones

Anti-Infective – Glycopeptide

Anti-Infective – Lincosamide

Anti-Infective – Macrolides

Anti-Infective – Penicillins and Cephalosporins

Anti-Infective – Sulfonamides

Anti-Infective – Tetracyclines

Atypical Antipsychotics

Autonomic Nervous System (ANS)

Sympathomimetics (Alpha (Clonodine) & Beta (Albuterol) Agonists)

Bronchodilators

Diuretics (Loop, Potassium Sparing, Thiazide, Furosemide/Lasix)

Proton Pump Inhibitors

HMG-CoA Reductase Inhibitors (Statins)

Magnesium Sulfate

Mood Stabilizers

Meds for Postpartum Hemorrhage (PPH)

Prostaglandins in Pregnancy

Rh Immune Globulin in Pregnancy

Lung Surfactant for Newborns

Eye Prophylaxis for Newborn

Phytonadione (Vitamin K) for Newborn

Opioid Analgesics in Pregnancy

Sedatives-Hypnotics

Anesthetic Agents

Corticosteroids

Betamethasone and Dexamethasone in Pregnancy

Nitro Compounds

ACLS (Advanced cardiac life support) Drugs

Anti-Infective – Aminoglycosides

Anti-Infective – Carbapenems

Anti-Infective – Macrolides

Anti-Infective – Fluoroquinolones

Anti-Infective – Sulfonamides

Anti-Infective – Tetracyclines

Anti-Infective – Antifungals

Anti-Infective – Antivirals

Anti-Infective – Lincosamide

Anticonvulsants

Antidiabetic Agents

Sympatholytics (Alpha & Beta Blockers)

Anti-Infective – Antitubercular

Anti-Infective – Glycopeptide

Bronchodilators

Anesthetic Agents

Antineoplastics

Alkylating Agents

Antimetabolites

Anti Tumor Antibiotics

Plant Alkaloids Topoisomerase and Mitotic Inhibitors

Patient Controlled Analgesia (PCA)

Acetaminophen (Tylenol) Nursing Considerations

Acyclovir (Zovirax) Nursing Considerations

Adenosine (Adenocard) Nursing Considerations

Albuterol (Ventolin) Nursing Considerations

Alendronate (Fosamax) Nursing Considerations

Alprazolam (Xanax) Nursing Considerations

Alteplase (tPA, Activase) Nursing Considerations

Amiodarone (Pacerone) Nursing Considerations

Amitriptyline (Elavil) Nursing Considerations

Amlodipine (Norvasc) Nursing Considerations

Amoxicillin (Amoxil) Nursing Considerations

Ampicillin (Omnipen) Nursing Considerations

ASA (Aspirin) Nursing Considerations

Atenolol (Tenormin) Nursing Considerations

Atorvastatin (Lipitor) Nursing Considerations

Atropine (Atropen) Nursing Considerations

Azithromycin (Zithromax) Nursing Considerations

Benztropine (Cogentin) Nursing Considerations

Bisacodyl (Dulcolax) Nursing Considerations

Bismuth Subsalicylate (Pepto-Bismol) Nursing Considerations

Bupropion (Wellbutrin) Nursing Considerations

Buspirone (Buspar) Nursing Considerations

Butorphanol (Stadol) Nursing Considerations

Calcium Acetate (PhosLo) Nursing Considerations

Calcium Carbonate (Tums) Nursing Considerations

Captopril (Capoten) Nursing Considerations

Carbamazepine (Tegretol) Nursing Considerations

Carbidopa-Levodopa (Sinemet) Nursing Considerations

Cefaclor (Ceclor) Nursing Considerations

Cefdinir (Omnicef) Nursing Considerations

Celecoxib (Celebrex) Nursing Considerations

Cephalexin (Keflex) Nursing Considerations

Chlorpromazine (Thorazine) Nursing Considerations

Cimetidine (Tagamet) Nursing Considerations

Ciprofloxacin (Cipro) Nursing Considerations

Clindamycin (Cleocin) Nursing Considerations

Clopidogrel (Plavix) Nursing Considerations

Codeine (Paveral) Nursing Considerations

Cortisone (Cortone) Nursing Considerations

Cyclosporine (Sandimmune) Nursing Considerations

Dexamethasone (Decadron) Nursing Considerations

Diazepam (Valium) Nursing Considerations

Digoxin (Lanoxin) Nursing Considerations

Diltiazem (Cardizem) Nursing Considerations

Dimensional Analysis Nursing (Dosage Calculations/Med Math)

Diphenhydramine (Benadryl) Nursing Considerations

Diphenoxylate-Atropine (Lomotil) Nursing Considerations

Divalproex (Depakote) Nursing Considerations

Dobutamine (Dobutrex) Nursing Considerations

Dopamine (Inotropin) Nursing Considerations

Enalapril (Vasotec) Nursing Considerations

Enoxaparin (Lovenox) Nursing Considerations

Epinephrine (EpiPen) Nursing Considerations

Epoetin (Epogen) Nursing Considerations

Erythromycin (Erythrocin) Nursing Considerations

Escitalopram (Lexapro) Nursing Considerations

Famotidine (Pepcid) Nursing Considerations

Fentanyl (Duragesic) Nursing Considerations

Ferrous Sulfate (Iron) Nursing Considerations

Fluoxetine (Prozac) Nursing Considerations

Fluticasone (Flonase) Nursing Considerations

Furosemide (Lasix) Nursing Considerations

Gabapentin (Neurontin) Nursing Considerations

Gentamicin (Garamycin) Nursing Considerations

Glipizide (Glucotrol) Nursing Considerations

Glucagon (GlucaGen) Nursing Considerations

Guaifenesin (Mucinex) Nursing Considerations

Haloperidol (Haldol) Nursing Considerations

Heparin (Hep-Lock) Nursing Considerations

Hepatitis B Vaccine for Newborns

Hydralazine (Apresoline) Nursing Considerations

Hydrochlorothiazide (Hydrodiuril) Nursing Considerations

Hydrocodone-Acetaminophen (Vicodin, Lortab) Nursing Considerations

Hydromorphone (Dilaudid) Nursing Considerations

Ibuprofen (Motrin) Nursing Considerations

Indomethacin (Indocin) Nursing Considerations

Insulin – Intermediate Acting (NPH) Nursing Considerations

Insulin – Long Acting (Lantus) Nursing Considerations

Insulin – Rapid Acting (Novolog, Humalog) Nursing Considerations

Insulin – Short Acting (Regular) Nursing Considerations

Iodine Nursing Considerations

Isoniazid (Niazid) Nursing Considerations

Ketorolac (Toradol) Nursing Considerations

Lactulose (Generlac) Nursing Considerations

Lamotrigine (Lamictal) Nursing Considerations

Levetiracetam (Keppra) Nursing Considerations

Levofloxacin (Levaquin) Nursing Considerations

Lidocaine (Xylocaine) Nursing Considerations

Lisinopril (Prinivil) Nursing Considerations

Lithium (Lithonate) Nursing Considerations

Loperamide (Imodium) Nursing Considerations

Lorazepam (Ativan) Nursing Considerations

Losartan (Cozaar) Nursing Considerations

Magnesium Sulfate (MgSO4) Nursing Considerations

Mannitol (Osmitrol) Nursing Considerations

Meperidine (Demerol) Nursing Considerations

Meropenem (Merrem) Nursing Considerations

Metformin (Glucophage) Nursing Considerations

Methadone (Methadose) Nursing Considerations

Methylergonovine (Methergine) Nursing Considerations

Methylphenidate (Concerta) Nursing Considerations

Methylprednisolone (Solu-Medrol) Nursing Considerations

Metoclopramide (Reglan) Nursing Considerations

Metoprolol (Toprol XL) Nursing Considerations

Metronidazole (Flagyl) Nursing Considerations

Midazolam (Versed) Nursing Considerations

Montelukast (Singulair) Nursing Considerations

Morphine (MS Contin) Nursing Considerations

Nalbuphine (Nubain) Nursing Considerations

Naproxen (Aleve) Nursing Considerations

Neostigmine (Prostigmin) Nursing Considerations

Nifedipine (Procardia) Nursing Considerations

Nitroglycerin (Nitrostat) Nursing Considerations

Nitroprusside (Nitropress) Nursing Considerations

Norepinephrine (Levophed) Nursing Considerations

Nystatin (Mycostatin) Nursing Considerations

Olanzapine (Zyprexa) Nursing Considerations

Omeprazole (Prilosec) Nursing Considerations

Ondansetron (Zofran) Nursing Considerations

Oxycodone (OxyContin) Nursing Considerations

Oxytocin (Pitocin) Nursing Considerations

Pancrelipase (Pancreaze) Nursing Considerations

Pantoprazole (Protonix) Nursing Considerations

Parasympatholytics (Anticholinergics) Nursing Considerations

Parasympathomimetics (Cholinergics) Nursing Considerations

Paroxetine (Paxil) Nursing Considerations

Pentobarbital (Nembutal) Nursing Considerations

Phenazopyridine (Pyridium) Nursing Considerations

Phenobarbital (Luminal) Nursing Considerations

Phenytoin (Dilantin) Nursing Considerations

Procainamide (Pronestyl) Nursing Considerations

Promethazine (Phenergan) Nursing Considerations

Propofol (Diprivan) Nursing Considerations

Propranolol (Inderal) Nursing Considerations

Propylthiouracil (PTU) Nursing Considerations

Quetiapine (Seroquel) Nursing Considerations

Ranitidine (Zantac) Nursing Considerations

Rifampin (Rifadin) Nursing Considerations

Salmeterol (Serevent) Nursing Considerations

Selegiline (Eldepyrl) Nursing Considerations

Sertraline (Zoloft) Nursing Considerations

Spironolactone (Aldactone) Nursing Considerations

Streptokinase (Streptase) Nursing Considerations

Sucralfate (Carafate) Nursing Considerations

Terbutaline (Brethine) Nursing Considerations

Tetracycline (Panmycin) Nursing Considerations

Trimethoprim-Sulfamethoxazole (Bactrim) Nursing Considerations

Uterine Stimulants (Oxytocin, Pitocin) Nursing Considerations

Vancomycin (Vancocin) Nursing Considerations

Vasopressin (Pitressin) Nursing Considerations

Verapamil (Calan) Nursing Considerations

Warfarin (Coumadin) Nursing Considerations

02.01 Hypertensive Crisis for CCRN Review