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Codeine

Cough Medicine Addiction


Presentation

  • The cause of these reactions is discussed and a review of the literature on the parenteral use of codeine phosphate is presented.[ncbi.nlm.nih.gov]
  • Erythema multiforme usually presents as an acute inflammatory reaction involving the skin and mucous membranes. Systemic symptoms and organ involvement also can occur. The disease is associated with many illnesses and drugs.[ncbi.nlm.nih.gov]
  • BACKGROUND: Acute pain is one of the most common presenting complaints in pediatric patients presenting to the emergency department.[ncbi.nlm.nih.gov]
  • Herein, two adolescent cases of TIN and TINU, seemingly developed secondary to paracetamol and codeine phosphate use, are presented.[ncbi.nlm.nih.gov]
  • AIMS: We present the application of Liese and Franz's (1996) cognitive developmental model of substance abuse to the trajectory from legitimate codeine use for pain, towards that of therapeutic and other forms of misuse, and physical and psychological[ncbi.nlm.nih.gov]
Splenomegaly
  • He had splenomegaly and generalized lymphadenopathy on admission. Laboratory examinations showed atypical lymphocytosis, eosinophilia, and increased liver enzyme values. The platelet count slowly decreased after admission.[ncbi.nlm.nih.gov]
Generalized Lymphadenopathy
  • He had splenomegaly and generalized lymphadenopathy on admission. Laboratory examinations showed atypical lymphocytosis, eosinophilia, and increased liver enzyme values. The platelet count slowly decreased after admission.[ncbi.nlm.nih.gov]
Aspiration
  • One child had to be admitted to the hospital, whereas the other one died at home after aspiration of gastric content.[ncbi.nlm.nih.gov]
  • Twin 1 required mechanical ventilation for 3 days, but he eventually made a full recovery; autopsy in twin 2 showed massive aspiration of gastric content.[ncbi.nlm.nih.gov]
Nausea
  • Symptoms can include cravings, sweating, runny nose, sleeping problems, yawning, cramps, weakness, nausea, diarrhea, chills, vomiting and irritability.[web.archive.org]
  • Common side effects include symptoms such as: Headache Nausea Weakness Anxiety Euphoria Itching Vomiting Dry mouth Constipation Depression Lack of sex drive Additionally, known side effects include dizziness and drowsiness, which can worsen with alcohol[opiates.com]
  • The available evidence indicates that codeine is more effective against cancer pain than placebo, but with increased risk of nausea, vomiting, and constipation.[ncbi.nlm.nih.gov]
  • ., nausea, p 0.05) subjective effects of codeine in both the FD120 and FD180 groups.[ncbi.nlm.nih.gov]
  • Hydrocodone exposures had more serious outcomes (11% vs. 9%; RR 0.82; 95% CI 0.73-0.91) and had more nausea (7.1% vs. 2.8%; RR 0.4; 95% CI 0.32-0.48) and vomiting (6.5% vs. 3.3%; RR 0.51; 95% CI 0.43-0.62).[ncbi.nlm.nih.gov]
Constipation
  • The available evidence indicates that codeine is more effective against cancer pain than placebo, but with increased risk of nausea, vomiting, and constipation.[ncbi.nlm.nih.gov]
  • Inability to pass urine Severe constipation and obstructed bowel Agitation Cold clammy skin with a bluish tinge Mental numbness Very slow, shallow breathing Hallucinations and sometimes seizures Coma and death 1 Long-term effects of codeine Regular use[adf.org.au]
  • General symptoms of opioid toxicity include confusion, somnolence, shallow breathing, small pupils, nausea, vomiting, constipation and lack of appetite.[web.archive.org]
  • Other side effects with the use of Codeine include headache, nausea, weakness, anxiety, euphoria, itching, vomiting, dry mouth, constipation, depression and lack of sex drive.[web.archive.org]
Vomiting
  • Symptoms can include cravings, sweating, runny nose, sleeping problems, yawning, cramps, weakness, nausea, diarrhea, chills, vomiting and irritability.[web.archive.org]
  • Common side effects include symptoms such as: Headache Nausea Weakness Anxiety Euphoria Itching Vomiting Dry mouth Constipation Depression Lack of sex drive Additionally, known side effects include dizziness and drowsiness, which can worsen with alcohol[opiates.com]
  • The available evidence indicates that codeine is more effective against cancer pain than placebo, but with increased risk of nausea, vomiting, and constipation.[ncbi.nlm.nih.gov]
  • A 3-year-old boy (twin 1) was found lying in vomit and apnoeic at night; he was resuscitated and immediately transferred to our paediatric intensive care unit (PICU).[ncbi.nlm.nih.gov]
  • Hydrocodone exposures had more serious outcomes (11% vs. 9%; RR 0.82; 95% CI 0.73-0.91) and had more nausea (7.1% vs. 2.8%; RR 0.4; 95% CI 0.32-0.48) and vomiting (6.5% vs. 3.3%; RR 0.51; 95% CI 0.43-0.62).[ncbi.nlm.nih.gov]
Epigastric Pain
  • We report the case of a 42-year-old man who suffered from epigastric pain 1 hour after taking a tablet containing amoxicillin plus clavulanic acid (500/125 mg) and another tablet containing acetaminophen plus codeine (500/30 mg) for a respiratory infection[ncbi.nlm.nih.gov]
Pruritus
  • Common adverse reactions: drowsiness, lightheadedness, dizziness, sedation, nausea and vomiting, euphoria, dysphoria, constipation, abdominal pain, pruritus, and rash.[www2.mallinckrodt.com]
  • . • Immune system disorders: (may be caused by histamine release) – including rash, urticaria, pruritus, difficulty breathing, increased sweating, redness or flushed face. • Nervous system disorders: confusion, drowsiness, malaise, tiredness, vertigo,[web.archive.org]
  • […] particularly in ambulatory patients not experiencing severe pain): lightheadedness, dizziness, sedation, nausea, vomiting, sweating. d e f When used at antitussive doses: nausea, vomiting, constipation (with repeated doses), dizziness, sedation, palpitation, pruritus[web.archive.org]
Urticaria
  • Scarlatiniform rash and urticaria were observed twice in the same patient following codeine intake. This rare drug-induced eruption may lead to mis-diagnosis in patients taking mild analgesics containing codeine.[ncbi.nlm.nih.gov]
  • Significant - Monitor Closely Sort by : Adverse Effects 10% Constipation Drowsiness 1-10% Hypotension Tachycardia or bradycardia Confusion Dizziness False feeling of well being Headache Lightheadedness Malaise Paradoxical CNS stimulation Restlessness Rash, urticaria[web.archive.org]
  • . • Immune system disorders: (may be caused by histamine release) – including rash, urticaria, pruritus, difficulty breathing, increased sweating, redness or flushed face. • Nervous system disorders: confusion, drowsiness, malaise, tiredness, vertigo,[web.archive.org]
Maculopapular Rash
  • About 20 days later, an erythematous, maculopapular rash appeared and progressed to erythroderma; a spiking fever also developed. He had splenomegaly and generalized lymphadenopathy on admission.[ncbi.nlm.nih.gov]
Impulsivity
  • Intrinsic network FC also correlated with higher impulsivity in CCS-dependent individuals (P 0.05, AlphaSim corrected).[ncbi.nlm.nih.gov]
  • It is a controlled substance. codeine sulfate/codeine phosphate, n generic codeine; drug class: narcotic analgesic, controlled substance schedule II, Canada N; action: depresses pain impulse transmission in central nervous system by interacting with opioid[medical-dictionary.thefreedictionary.com]
  • Enkephalin molecules are released from a nerve cell and bind to analgesic receptor sites on the nerve cell sending the impulse.[web.archive.org]
Ataxia
  • Cardiovascular side effects, ataxia, and headache occurred equally between the groups. CONCLUSIONS: Both drugs had a wide array of reported side effects, but the overall incidence of serious outcomes was low. Copyright 2016 Elsevier Inc.[ncbi.nlm.nih.gov]
  • Adverse Reactions and Overdosage The principal clinical manifestations of codeine toxicity are respiratory depression and obtundation. 14 , 15 In children, antitussive dosages of 3 to 5 mg/kg/d have produced somnolence, ataxia, miosis, vomiting, rash,[pediatrics.aappublications.org]
Tonic-Clonic Seizure
  • The patient immediately developed a tonic-clonic seizure, which was treated with intravenous diazepam and naloxone.[ncbi.nlm.nih.gov]
  • Seven days after starting codeine therapy, the woman became stuporous and developed tonic-clonic seizures. After phenytoin initiation, codeine discontinuation, and naloxone administration, the seizures did not recur.[ncbi.nlm.nih.gov]

Workup

Testosterone Decreased
  • The circulatory concentration of total testosterone decreased significantly by 20% after 3 days' use of codeine (p 0.0002) and an atypical ABP result was noted in one of the subjects.[ncbi.nlm.nih.gov]
Human Herpesvirus 6
  • A significant increase in IgG antibodies to human herpesvirus 6 (HHV6) and transient viremia were helpful in diagnosing hypersensitivity syndrome. The results of patch tests were positive for codeine phosphate.[ncbi.nlm.nih.gov]

Treatment

  • Thirty patients were assessed (all white, age 40 12 years using 127 79 mg/day of codeine [mean SD]), and 17 entered treatment. Eight patients remained in the study by treatment week 8.[ncbi.nlm.nih.gov]
  • INTRODUCTION AND AIMS: Few studies have described those seeking treatment for codeine dependence.[ncbi.nlm.nih.gov]
  • We sought randomised, double-blind, controlled trials using single or multiple doses of codeine, with or without paracetamol, for the treatment of cancer pain.[ncbi.nlm.nih.gov]

Prognosis

Etiology

  • The disease is divided into several categories based on the underlying etiology, with the drug-induced variant comprising a rising number of the total cases and being reported in association with an increasing number of medications.[ncbi.nlm.nih.gov]
  • Mortality and major morbidity after tonsillectomy: etiologic factors and strategies for prevention. Laryngoscope 2013. In press.[web.archive.org]
  • Historically, codeine was considered an optimal oral analgesic for the outpatient treatment of acute pain of various etiologies in children, partly because of the perception that it was a safe opioid analgesic with a wide therapeutic index and a limited[doi.org]

Epidemiology

  • Analysing drug residues in wastewater (wastewater analysis) to monitor the consumption of those drugs in the population has become a complementary method to epidemiological surveys.[ncbi.nlm.nih.gov]
  • Despite these recommendations, the epidemiology of codeine use among children remains unknown. AIMS: Our objective was to examine patterns of codeine use in the US among children.[ncbi.nlm.nih.gov]
  • According to the latest statistics from the South African Community Epidemiology Network on Drug Use (Sacendu), released in February this year, 2% or 225 patients at drug abuse treatment centres had reported the misuse of codeine-containing drugs with[iol.co.za]
Sex distribution
Age distribution

Pathophysiology

  • The most likely underlying pathophysiological mechanism was probably codeine-induced spasm of the sphincter of Oddi combined with sphincter of Oddi dysfunction related to a previous cholecystectomy.[ncbi.nlm.nih.gov]
  • The likely underlying pathophysiological mechanism is codeine-induced spasm of the sphincter of Oddi combined with sphincter of Oddi dysfunction related to a previous cholecystectomy.[ncbi.nlm.nih.gov]

Prevention

  • Our efforts represent an evidence-based, innovative medication safety strategy to prevent adverse drug events, which is a model for the use of pharmacogenetics to optimize drug therapy in specialized pediatric populations.[ncbi.nlm.nih.gov]
  • The need for special instructions for its intravenous administration may prevent this type of reaction, especially in patients in need of acute pain control requiring intravenous narcotics.[ncbi.nlm.nih.gov]
  • Use proper storage and disposal, to help prevent abuse. Take action by having frequent conversations with the teens and young adults in your life about the dangers of medicine abuse. Learn how.[medicineabuseproject.org]
  • Until then, tailored communication reinforcement toward health-care professionals is needed to prevent these problematic occurrences of concomitant prescription administration.[ncbi.nlm.nih.gov]
  • […] participant profile and product preferences, motives for use, transitioning to misuse and dependence, pharmacy purchasing and alternative sourcing routes, effects and withdrawal experiences, help-seeking and treatment experiences, and strategies for prevention[ncbi.nlm.nih.gov]

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