Analgesic ingestion

Piper DW, McIntosh JH, Ariotti DE, Fenton BH, MacLennan R. Analgesic ingestion and chronic peptic ulcer. Gastroenterology 1981 80(3) 427-32. 

Rampton DS, McNeil NI, Sarner M. Analgesic ingestion and other factors preceding relapse in ulcerative cohtis. Gut 1983 24(3) 187-9. 

The most frequently observed symptoms include vomiting (82%), nausea (74%), abdominal cramps (64%), diarrhea (64%), and also headaches and muscular cramping. The onset of symptoms usually starts after 6 to 10 hours after food ingestion, however they may be reported earlier. The lethal cases are rare and occur among infants and elderly people. Only 10% of affected people need medical treatment - treatments include analgesics, antidiarrheic drugs, and administration of fluids. 

Methadone, used as an analgesic, may be dispensed in any licensed pharmacy. Methadone dispersible tablets are for oral administration only. This preparation contains insoluble excipients and therefore must not be injected. It is recommended that methadone dispersible tablets, if dispensed, be packaged in child-resistant containers and kept out of the reach of children to prevent accidental ingestion. 

Propoxyphene (dextropropoxyphene Darvon) is structurally related to methadone but is much less potent as an analgesic. Compared with codeine, propoxyphene is approximately half as potent and is indicated for the treatment of mild pain. It is not antipyretic or antiinflammatory like aspirin and is less useful than aspirin in most cases of mild pain. Toxicity from propoxyphene, especially in combination with other sedatives, such as alcohol, has led to a decrease in its use. Death following ingestion of alcohol in combination with propoxyphene can occur rapidly (within 20 minutes to 1 hour). The drug is not indicated for those with histories of suicide or depressive illnesses. 

The gastrointestinal tract responds to a number of toxic substances, usually by pain, vomiting, or paralytic ileus (see Intestines, Section 6.4.5). Severe gastrointestinal pain is symptomatic of poisoning by arsenic or iron. Both of these substances can cause vomiting, as can acids, bases, fluorides, salicylates, and theophyllin. Paralytic ileus can result from ingestion of narcotic analgesics, tricyclic antidepressants, and clonidine. 

Codeine Phosphate The presence of aspirin along with codeine, even at a low moisture level, leads to acetylation of codeine phosphate in solid dose forms and is incompatible.36 Codeine sulfate solutions are more stable than phosphate salts.37 Drug dependence and withdrawal resemble that of opioid analgesics. Overdose causes acute intoxication in children, as accidental or deliberate ingestion of cough preparations containing codeine.38... 

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