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Discussion Of Codeine Sulfate : Use In Specific Populations

Discussion Of Codeine Sulfate

Pregnancy :

Teratogenic Results –

Codeine use in specific populations discussion

Pregnancy Category C

There are no able and well-controlled studies in abundant women. Codeine should be acclimated during abundance alone if the abeyant account justifies the abeyant accident to the fetus.

Codeine use in specific populations discussion

Codeine use in specific populations discussion

Codeine has been apparent to accept embryolethal and fetotoxic furnishings (reduced fetal anatomy weights and delayed or abridged ossification) in the hamster, rat and abrasion models at about 2-4 times the best recommended animal dosage of 360 mg/day based on a anatomy apparent breadth comparison. Maternally baneful doses that were about 7 times the best recommended animal dosage of 360 mg/day, were associated with affirmation of resorptions and abridged ossification, including the meningio encephalocele and the cranioschisis. In contrast, codeine did not authenticate affirmation of embrytoxicity or fetotoxicity in the aerial archetypal at doses up to 2 times the best recommended animal dosage of 360 mg/day based on a anatomy apparent breadth comparison.

Codeine use in specific populations discussion

Nonteratogenic Results –

Codeine use in specific populations discussion

Neonatal codeine abandonment has occurred in breed built-in to absorbed and non-addicted mothers who had been demography codeine-containing medications in the canicule above-mentioned to delivery. Typical affection of analgesic abandonment accommodate irritability/boundless crying/tremors/hyperreflexia/seizures/fever/vomiting/diarrhea and poor feeding. These signs action anon afterwards bearing and may crave specific treatment.

Codeine use in specific populations discussion collected unique pic no-17.

Codeine (30 mg/kg) administered subcutaneously to abundant rats during abundance and for 25 canicule afterwards commitment added neonatal bloodshed at birth. This dosage is 0.8 times the best recommended animal dosage of 360 mg/day on a anatomy apparent breadth comparison.

Codeine use in specific populations discussion

Codeine use in specific populations discussion

Labor and Delivery

Opioid analgesics cantankerous the placental barrier and may aftermath respiratory abasement and psycho-physiologic furnishings in neonates. Occasionally, opioid analgesics may prolong action through accomplishments which briefly abate the strength, duration, and abundance of uterine contractions. However, this aftereffect is not constant and may be account by an added bulk of cervical dilatation, which tends to abbreviate labor. The afterpiece to commitment and the beyond the dosage used, the greater the achievability of respiratory abasement in the newborn. Opioid analgesics should be abhorred during action if commitment of a abortive babyish is anticipated. If the mother has accustomed analgesic analgesics during labor, bairn breed should be empiric anxiously for signs of respiratory depression. Resuscitation may be required. A specific opioid antagonist, such as naloxone or nalmefene, should be accessible for changeabout of opioid-induced respiratory abasement in the neonate.

Codeine use in specific populations discussion

Nursing Mothers

Codeine is buried into animal milk. In women with accustomed codeine metabolism (normal CYP2D6 activity), the bulk of codeine buried into animal milk is low and the dose-dependent. However, some of the women are ultra-rapid metabolizers of the codeine. These women accomplish higher-than-expected serum levels of codeine’s alive metabolite, morphine, arch to higher-than-expected levels of morphine in breast milk and potentially alarmingly aerial serum morphine levels in their breastfed infants. Therefore, affectionate use of codeine can potentially advance to austere adverse effects with death, in the nursing infants.

Codeine use in specific populations discussion

The accident of babyish acknowledgment to codeine and morphine through breast milk should be advised adjoin the allowances of breastfeeding for both the mother and the baby. Caution should be acclimatized back codeine is administered to a nursing woman. If a codeine absolute artefact is selected, the everyman dosage should be assigned for the beeline aeon of time to accomplish the adapted analytic effect. Mothers application codeine should be abreast about back to seek actual medical affliction and how to analyze the signs and affection of neonatal toxicity, such as blackout or sedation, adversity breastfeeding, breath difficulties, and decreased the tone in their baby. Nursing mothers who and whose are the ultra-rapid metabolizers may additionally acquaintance balance affection such as acute sleepiness, confusion, or bank breathing. Prescribers should anxiously adviser mother-infant pairs and acquaint alleviative pediatricians about the use of codeine during breastfeeding.

Codeine use in specific populations discussion

Pediatric Use

Codeine use in specific populations discussion

The assurance and capability and the pharmacokinetics of Codeine Sulfate in pediatric patients beneath the age of 18 accept not been established. FDA has not appropriate pediatric studies in ages bearing to one ages because there is affirmation acerb suggesting that codeine would be abortive in this pediatric accumulation back the metabolic pathways to metabolize codeine are not mature.

Codeine use in specific populations discussion

Respiratory abasement and afterlife accept occurred in accouchement with adverse beddy-bye apnea who accustomed codeine in the postoperative aeon afterward tonsillectomy and/or adenoidectomy and had affirmation of actuality ultra-rapid metabolizers of codeine (i.e., assorted copies of the gene for cytochrome P450 isoenzyme 2D6 or aerial morphine concentrations). These accouchement may be decidedly acute to the respiratory biologic furnishings of codeine that has been rapidly metabolized to the morphine. Codeine is strongly contraindicated for the post-operative affliction administration in all pediatric patients ability tonsillectomy and/or adenoidectomy.

Codeine use in specific populations discussion

Codeine use in specific populations discussion

Geriatric Use

Codeine may account abashing and over-sedation in the elderly. In general, dosage alternative for an aged accommodating should be cautious with usually start at the low end of the dosing range, absorption the greater abundance of decreased hepatic, renal, or cardiac function, and of accessory ache or added biologic therapy.

Codeine use in specific populations discussion

Codeine use in specific populations discussion

Renal Impairment

Codeine pharmacokinetics may be adapted in patients with renal/kidney failure. Clearance may not be increased with the metabolites may accrue to abundant college claret levels in patients with renal abortion as compared to patients with accustomed renal function. Start these patients anxiously with lower doses of Codeine Sulfate or with best dosing intervals and titrate boring while anxiously ecology for ancillary effects.

Codeine use in specific populations discussion

Hepatic Impairment

No academic studies accept been conducted in patients with the hepatic impairment. So the pharmacokinetics of the codeine in this accommodating citizenry are unknown. Start these patients anxiously with lower doses of Codeine Sulfate or with best dosing intervals and titrate boring while anxiously ecology for ancillary effects.

About Dr. Md. Kafil - Uddin Sarker Akash

Short Biography Of The Hon’ble Chairman : Dr. Md. Kafil – Uddin Sarker Akash, Hon’ble Chairman, Bangladesh Preventive Welfare Society of Suicide-Addiction-Narcotics & Pollution(BPWS of SANP), was born on December 31 (Thirty One), 1982 in the Village : Nilam Kharida Sadra, P.O- Vayerhat, P.S- Kaunia, District- Rangpur, Country- Bangladesh. He is the son of Md. Nurul Islam and Most. Noorjahan Begum. Having obtained Bachelor of Medicine and Bachelor of Surgery (M.B.B.S) under University of Rajshahi, Bangladesh and he was enrolled as a Registered Doctor from “ Bangladesh Medical & Dental Council” -(BM&DC) ; And achieved Post-Graduation Degree on Forensic Medicine (D.F.M) ; Under Bangabandhu Sheikh Mujib Medical University(BSMMU), Bangladesh and Also achieved (M.C.P.S) Membership, From Bangladesh College of Physician & Surgeons -(B.C.P.S). Currently, he is Fellow in Phd Research Program at Institute of Biological Science under University of Rajshahi, Bangladesh. He practiced as Reputed Physician and Work as a Autopsy Surgeon through conducted several Post-mortem Examinations and delivered huge expert Medico-Legal Opinion under Court of Law to aid for Administration of Justice. In additionally, he participate in many short and long time training program, Scientific Seminar, Symposium and Obtained many of the Training Certificates. He also conducted and taken Lecture Class in different Medical Colleges of Bangladesh for a longer period of time. Thus, he get opportunity to build intimacy and make friendly relationship among with the huge students and try to understand psychology of different level students. He also build and make intimacy with the huge General Peoples through visited on different region locally, internationally and See how to suffer the peoples due to anxiety, stress, depression, addiction, abuse and dependence, effects of different pollution, contamination and intoxication, harmful effects due to destruction of nature and natural environment, effects of climate change and suffer different health hazards for that reasons etc. Thus, he inspire and encouraged for doing something of the human being, that would be ensure welfare need of the world peoples.

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