Darvocet and Lortab

In a pinch, if its all you've got and you can't get anything more appropriate at that moment and you are desparate to give some pain relief while you are working on getting hold of a physician to get an order for something like Roxanol...you can give most oral meds rectally but they are formulated to break down in the gastric juices so there will be differences in absorbtion time and effectiveness. The contents of the rectal vault may also affect the results. I would consider it a one time emergency type order.

Darvocet in general should be avoided because it is not tolerated well by the elderly. Propoxyphene will often cause confusion and its toxic metabolite, norpropoxyphene, can build up in persons who have renal impairment. Since studies have shown that propoxyphene is marginally, if any, more potent than aspirin or acetaminophen, there are many better choices for pain control.

as a last resort i have given meds rectally, depending on how they're metabolized.
you want to ensure the rectal vault is clear of stool...and i have crushed meds mixed with a smidge of water (paste consistency) for the benefit of mucosal absorbency.

and darvocet is not only contraindicated in elderly, it's laughable as an analgesic.

if this patient is not obtaining pain relief, i would document the poor effect of said meds in your notes; report the lack of relief to the md and also document his response.
it also might not be a bad idea to have a pharmacist talk with the md about darvocet being contraindicated.

much luck to you and your pt.

leslie