vision, hallucinations, mental confusion, and shortness of breath. This medication
should be used with caution in-patients who have a history of drug abuse or
dependence. The oral dosage form (Talwin NX) is combined with naloxone, a narcotic
antagonist, to discourage the abuse of this substance. When the tablet is dissolved and
then injected, the naloxone negates the euphoric effects of the pentazocine. Patients
taking pentazocine should not take alcohol or any other central nervous system
depressant at the same time, since this agent is a central nervous system depressant.
g. Butalbital with Aspirin and Caffeine (Fiorinal). This product contains
butalbital (a short-to-intermediate-acting barbiturate--50 mg), aspirin (325 mg), and
caffeine (40 mg). The product is used as an analgesic. Side effects associated with
this agent are gastrointestinal upset and sedation. This product may cause drug
dependence. Patients taking this drug should not take any alcohol or any other central
nervous system depressant. Fiorinal is a Note Q controlled substance. (NOTE:
Fiorinal with Codeine is another formulation of this product. It is used to raise the
threshold of pain.)
Section III. ANTI-INFLAMMATORY AGENTS
4-5. BACKGROUND
In certain conditions (that is, arthritis) or injuries, affected tissues become
inflamed. The net effect of such inflammation is to surround the affected area and "wall
it off" so that the movement of toxic products or bacteria from the affected part is
delayed. Blood flow to the area is increased and certain changes happen in the
capillaries to increase the fluid level of the tissues. Hence, the area becomes swollen.
Redness of the area follows. Although this is a protective mechanism for the body, it is
desirable at times to use drugs to decrease this effect.
4-6. SPECIFIC ANTI-INFLAMMATORY AGENTS
a. Indomethacin (Indocin). Indomethacin is used in the treatment of various
medical problems, including certain types of arthritis. Indomethacin is used to relieve
swelling, inflammation, joint pain, stiffness, and fever. Patients hypersensitive to aspirin
may also be hypersensitive to indomethacin. Side effects associated with the agent are
gastrointestinal upset, headache, dizziness, and ringing or buzzing in the ears. Patients
should be instructed to take this medication with food or milk or right after meals in order
to lessen the possibility of gastrointestinal upset. Furthermore, in order to lessen
gastrointestinal upset, patients should be instructed not to regularly drink alcoholic
beverages or take aspirin unless their physician has told them otherwise. Since the
drug does have the side effect of dizziness, the patient should be told not to drive or
operate hazardous machinery until he or she has been taking the drug and has
determined its effects on alertness.
MD0805
4-4