Drug Study

Drug Name
Generic
hydrocodon
e/
acetaminop
hen
Trade
Vicodin

Classificati
on
Narcotic
Analgesic

Indications
Moderate to
moderately
severe pain.
Short-term
pain due to an
injury, surgery,
or dental
procedure.
Occasionally, it
is used to treat
chronic
pain, migraines
, or other types
of recurring,
long-term
conditions that
cause pain.

Mechanism of Action
Blocks release of
inhibitory
neurotransmitters,
altering perception
of and emotional
response to pain.
Hydrocodone/ibuprof
en combination
raises pain threshold
by nonselectively
inhibiting
cyclooxygenase;
prostaglandin
synthesis then
decreases and antiinflammatory and
analgesic effects
occur.
Acetaminophen is a
non-narcotic
analgesic (pain
reliever) and
antipyretic (fever
reducer).
Acetaminophen
works by elevating
the threshold to
pain, that is, in order
for pain to be felt,
greater stimulation
of the nerves
responsible for the

Route/Frequency/Do
sage
The usual dose for
adults is 1 to 2
tablets or capsules
(hydrocodone 2.5 to
10 mg;
acetaminophen 300
to 750 mg) every 4
to 6 hours or 15 mL
of liquid every 4 to 6
hours as needed.

Adverse Reactions
CNS: confusion,
drowsiness,
sedation,
dysphoria,
euphoria, floating
feeling,
hallucinations,
headache, anxiety,
depression, fatigue,
insomnia, lethargy,
nervousness,
slurred speech,
tremor, asthenia,
unusual dreams
CV: orthostatic
hypotension,
bradycardia,
peripheral edema,
palpitations, arrhyth
mias
EENT: blurred
vision, vision
changes, diplopia,
miosis, tinnitus,
pharyngitis, rhinitis,
sinusitis
GI: nausea,
vomiting,
constipation,
dysphagia,
esophagitis,
dyspepsia,
flatulence, gastritis,

Drug Interaction
Combining
alcohol and
other sedatives
with
hydrocodone
can lead to
increased
sedation and
even cause
confusion.
Combining
carbamazepine
(Tegretol,
Tegretol XR ,
Equetro,
Carbatrol) with
acetaminophen
may increase
the risk of liver
toxicity.

Nursing
Consideration
In prolonged use,
monitor for
psychological and
physical
dependence.
Watch closely for
withdrawal
symptoms when
drug is
discontinued.
Assess elderly
patients carefully
for adverse
reactions.
Monitor for signs and
symptoms of drug
overdose, including
nausea, vomiting,
blurred vision, cool
and clammy skin,
dizziness,
confusion, dyspnea,
respiratory
depression,
bradycardia,
hearing loss,
tinnitus, headache,
and mood or
behavior changes.
Patient teaching
Tell patient drug may
cause drowsiness.

sensation of pain is
necessary. It reduces
fever through its
action on the
temperatureregulating center of
the brain.
Frequently,
hydrocodone and
acetaminophen are
combined to achieve
pain relief, as in
Vicodin and Lortab.

gastroenteritis,
mouth ulcers, dry
mouth, anorexia
GU: urinary
retention or
frequency, erectile
dysfunction
Respiratory: respirat
ory depression,
bronchitis, dyspnea
Skin: pruritus,
urticaria,
diaphoresis,
flushing
Other: physical or
psychological drug
dependence, drug
tolerance

Caution him to
avoid driving and
other hazardous
activities until CNS
effects are known.
Inform patient that
prolonged use may
lead to physical or
psychological
dependence.
Caution patient to
avoid alcohol during
therapy.
Instruct patient to
move slowly when
sitting up or
standing, to avoid
dizziness from
sudden blood
pressure decrease.
As appropriate,
review all other
significant and lifethreatening adverse
reactions and
interactions,
especially those
related to the
drugs, tests, herbs,
and behaviors
mentioned above.