Discussion Of Codeine Sulfate : Drug Abuse And Dependence, Overdose Symptoms And Treatment

Dr. Md. Kafil - Uddin Sarker Akash December 6, 2015 Narcotics 1 Comment 3,273 Views

Controlled Substance

Codeine Sulfate is an opioid agonist and is a Schedule II controlled substance. Codeine Sulfate can be abused and is accountable to bent diversion.

Abuse

Drug addiction is characterized by besetting use, use for non-medical purposes, and connected use admitting corruption or accident of harm. Biologic addiction is a treatable diseases, utilizing with a multidisciplinary approach, but backsliding is common. “Drug seeking” behavior is actual accepted in addicts and biologic abusers. Drug-seeking approach accommodate emergency calls or visits abreast the end of appointment hours, abnegation to abide adapted examination, testing or referral, again “loss” of prescriptions, analytical with prescriptions and abhorrence to accommodate above-mentioned medical annal or acquaintance advice for added alleviative physician(s). “Doctor shopping” to access added prescriptions is accepted amid biologic abusers and bodies adversity from basic addiction.

Abuse and addiction are abstracted and audible from concrete assurance and tolerance. Physicians should be acquainted that addiction may not be accompanied by circumstantial altruism and affection of concrete dependence. The antipodal is additionally true. In addition, corruption of opioids can activity in the absence of accurate addiction and is characterized by abusage for non-medical purposes, generally in aggregate with added consciousness-expanding substances. Careful recordkeeping of prescribing information, including quantity, frequency, and face-lifting requests is acerb advised.

Codeine is advised for articulate use only. Corruption of codeine poses a accident of balance and death. The accident is added with circumstantial corruption of booze and added substances. Parenteral biologic corruption is frequently associated with manual of communicable diseases such as hepatitis and HIV.

Proper appraisal of the patient, able prescribing practices, alternate reevaluation of therapy, and able dispensing and accumulator are adapted measures that advice to absolute corruption of opioid drugs.

Infants built-in to mothers physically abased on opioids will additionally be physically abased and may display respiratory difficulties and abandonment symptoms.

Dependence

Tolerance is the charge for accretion doses of opioids to advance a authentic aftereffect such as analgesia (in the absence of ache progression or added alien factors). Concrete assurance is embodied by abandonment affection afterwards brusque cessation of a biologic or aloft administering of an antagonist. Concrete assurance and altruism are not abnormal during abiding opioid therapy.

The opioid abnegation or abandonment affection is characterized by some or all of the following: Restlessness/lacrimation/rhinorrhea/yawning/perspiration/chills/myalgia and mydriasis. Added affection additionally may develop, including irritability, anxiety, backache, collective pain, weakness, belly cramps, insomnia, nausea, anorexia, vomiting, diarrhea, or added claret pressure, respiratory rate, or affection rate.

In general, Opioids not should be abruptly discontinued/stoped.

Overdosage

Symptoms

Acute balance of codeine is characterized by respiratory abasement (a abatement in respiratory amount and/or flat volume, Cheyne-Stokes respiration, cyanosis), astute blackout advanced to amazement or coma, miosis (mydriasis may activity in terminal befuddlement or astringent hypoxia), ashen beef flaccidity, algid and close skin, and sometimes bradycardia and hypotension. In astringent overdosage/apnea/circulatory collapse/cardiac arrest and afterlife may occur.

Codeine Sulfate may account miosis, alike in absolute darkness. Pinpoint pupils are a assurance of opioid balance but are not for pathognomonic (e.g. pontine lesions of the hemorrhagic/ischemic agent may aftermath agnate findings). Marked mydriasis rather than miosis may be apparent with hypoxia in balance situations.

Treatment

Primary absorption should be accustomed to the reestablishment of able respiratory barter through accouterment of a apparent airway and academy of assisted or controlled blast as essential/necessary. Supportive measurements (including for oxygen/vasopressors) should be active in the administering of circulatory shock and pulmonary edema accompanying balance as indicated. Cardiac arrest or arrhythmias may crave cardiac beating or, the defibrillation. Induction of the emesis is not be recommended because of the abeyant for CNS(Central Nervous System) abasement and the seizures. Activated charcoal is recommended for that if the accommodating is alive and able to assure his/her airway. In bodies who are at accident for brusque access of seizures or brainy cachet depression, activated charcoal should be administered by medical or paramedical cadre able of airway administering to anticipate aspiration in the accident of ad-lib emesis. Astringent agitation or seizures should be advised with an intravenous benzodiazepine.

The opioid adversary naloxone hydrochloride is a specific antitoxin adjoin respiratory abasement consistent from overdosage or abnormal acuteness to analgesic agonists, including codeine. Therefore, an adapted dosage of naloxone hydrochloride (see prescribing advice for naloxone hydrochloride) should be administered, finer by the intravenous route, accompanying with efforts at respiratory resuscitation. Since the continuance of activity of codeine may beat that of the antagonist, the accommodating should be kept beneath connected surveillance and again doses of the adversary should be administered as bare to advance able respiration. A analgesic adversary should not be administered in the absence of clinically cogent respiratory or cardiovascular abasement accessory to Codeine Sulfate overdose.

In an alone physically abased on opioids, administering of the accepted dosage of the adversary will accelerate an astute abandonment syndrome. The severity of the abandonment affection accomplished will depend on the amount of concrete assurance and the dosage of the adversary administered. Use of an opioid adversary should be aloof for cases area such analysis is acutely needed. If it is all-important to amusement austere respiratory abasement in the physically abased patient, administering of the adversary should be accomplished with affliction and titrated with abate than accepted doses.

Description Of Codeine Sulfate

Chemically, codeine is Morphinan-6-ol/7/8-didehydro-4/5-epoxy-3(three)-methoxy-17(seventeen)-methyl-(5α/6α)-/sulfate (2:1) (salt)/ trihydrate. It is atomic blueprint is C18H21NO3 and its atomic weight is 299.36. Its anatomy is as follows:

Each book contains 15, 30, or 60 mg of Codeine Sulfate and the afterward abeyant ingredients: microcrystalline cellulose, colloidal silicon dioxide, magnesium stearate, crumb and stearic acid.