Cough suppression codeine

Opium poppy (Papaver somniferum), one of the oldest cultivated plants has been used in medicine since the beginning of civilization [221 ]. To date, it is the only commercial source of the narcotic drag morphine, the cough suppressant codeine and the antitumor agent noscapine. In addition to the substances mentioned above, poppy plants contain about eighty different... 

In addition, morphine has served as a point of departure for the discovery of many medically usefnl derivatives. These inclnde codeine, a pain reliever and cough suppressant, levophanol, an orally active analgesic (morphine is not active when given orally and is nsnally given by injection), and many other modem and highly potent opiate analgesics. 

Codeine, dextromethorphan and pholcodine are opioid cough suppressants indicated for dry cough. Sedating antihistamines, such as diphenhydramine, tend to have an antitussive action as well. Vitamin C is not used in the management of cough but may be used as a prophylaxis against colds. 

Dextromethorphan is an opioid antitussive similar in action to codeine and pholcodine. Codeine and pholcodine are considered to be more potent than dextromethorphan. Dextromethorphan tends to cause less constipation and dependence than codeine. Cough suppressants are not usually recommended in children under 2 years. 

The cough-suppressant (antitussive) effect produced by inhibition of the cough reflex is independent of the effects on nociception or respiration (antitussives codeine, noscapine). 

Hydrocodone is an opium analgesic (pain reliever) and antitussive (cough suppressant). It is related in structure to other alkaloids used as drugs, such as morphine and codeine (see Section 8). It increased 20% in number of prescriptions for one year. Its synthesis from codeine is by simple reactions. 

Codeine occurs naturally in opium but the amount is too small to be useful. It is prepared from morphine by methylating the phenolic hydroxyl group with diazomethane, dimethyl sulfate, or methyl iodide. Codeine does not possess the same degree of analgesic potency as morphine but is used as an antitussive, a cough suppressant. Hydrocodone was discussed in Section 3.4. It is made from codeine. 

Pharmacology Dextromethorphan is the d-isomer of the codeine analog of levorphanol. Its cough suppressant action is due to a central action on the cough center in the medulla. Dextromethorphan 15 to 30 mg equals 8 to 15 mg codeine as an antitussive. 

Alkaloids such as boldine, codeine, narceine and morphine are active factors in their receptors. Boldine has morphine-like properties and is active on opioid receptors. It may be used to treat stomach disorders and as metabolic stimulant. As it is similar to morphine, boldine can also be considered in the possible development of treatments for narcotic dependence. Codeine also binds to opiate receptors, and specifically functions to reduce bronchial secretions. Codeine can also be used as a cough suppressant when acting on the centre of the medulla oblongata and as a sedative agent. 

Cough may be dry or productive. A centrally acting cough suppressant can be tried in dry cough first choice treatment is noscapine which is safer and has less adverse reactions than codeine and ethyl morh-pine. 

Codeine is a close chemical relative of morphine, differing in only one chemical group. Once administered, codeine is actually metabolized by enzymatic action, and its actions mimic those of morphine. Codeine is used primarily as a cough suppressant, although it certainly also possesses significant analgesic properties (approximately one tenth those of morphine) as in the relief of pain from toothache. 

Codeine is a natural alkaloid found in the opium plant. As a pharmaceutical, codeine is used as an analgesic, antitussive, and antidiar-rheal. Codeine is also commonly combined with other cough suppressants as well as with aspirin and ibuprofen. In the United States, codeine is a Schedule III controlled substance, which means that its distribution is more tightly regulated than unscheduled drugs. Codeine has pain-relieving qualities principally because, once in the body, about 10 percent of codeine turns into morphine. This conversion occurs in the liver, where an enzyme changes codeine s... 

As with all drugs, codeine has some undesirable effects in addition to its therapeutic effects. At the usual cough suppressing doses (see below), codeine may cause nausea—the medical term for upset stomach accompanied by the sensation of queasiness— which makes you feel as if you are about to regurgitate (vomit, or throw up ). Codeine may cause vomiting... 

Brontex and Guiatussin with Codeine are two brand-name cough suppressants available in tablet form. They contain 10 mg of codeine plus the expectorant guaifenesin. (An expectorant helps expel mucus secretions from the airways.)... 

As discussed in Chapter 2, the primary medical uses of codeine are for the relief of pain, cough suppression, and to control diarrhea. Codeine is commercially produced as tablets, either alone (Schedule II), in combination with aspirin or acetaminophen (Schedule III), or as a liquid preparation for suppressing cough suppressant (Schedule V). 

Codeine in iiquid form for use as a cough suppressant (e.g., Robitussin A-C , Cheracoi , Pediacof ) is a Scheduie V drug. 

Suppression of the cough reflex is a well-recognized action of opioids. Codeine in particular has been used to advantage in persons suffering from pathologic cough and in patients in whom it is necessary to maintain ventilation via an endotracheal tube. However, cough suppression by opioids may allow accumulation of secretions and thus lead to airway obstruction and atelectasis. 

Antitussives Codeine, 10-20 mg every 4-6 hours, not to exceed 120 mg in 24 hours (with guaifenesin) Guiatuss AC, Mytussin AC, various generic Acts centrally to increase the cough threshold. In doses required for cough suppression, the addiction liability associated with codeine is low. Many codeine-containing antitussive combinations are schedule V narcotics, and OTC sale is restricted in some states. 

Analgesic efficacy and medical use Ethylmorphine has an action profile similar to codeine with analgesic, antitussive and antidiarrheal properties. It has been used in similar circumstances to codeine as a cough suppressant and analgesic, but today it is mostly out of use. 

The effects of morphine, codeine, and heroin in the brain are dose-related. Small doses produce drowsiness, decreased anxiety and inhibition, reduced concentration, muscle relaxation, pain relief, depressed respiration, constricted pupils, nausea, and a decreased cough reflex, which is why codeine found its way into cough suppressants. At slightly higher doses, morphine and heroin can produce a state of intense elation or euphoria. 

Codeine is not routinely sold in the United States as an individual drug. It is combined instead with one or more other OTC analgesics or cough suppressants into a single compound medication. Codeine is familiar to most people as an ingredient in a series of analgesic preparations in combination with Tylenol-brand acetaminophen. The number after Tylenol designates the amount of codeine in each tablet ... 

Codeine is most often used in the treatment of mild to moderate pain that does not respond fully to OTC analgesics. A number of different cough-suppressant (antitussives) medications contain low concentrations of codeine. The effects of codeine on the nerves and muscles of the intestines make it an effective treatment for diarrhea. However, since equally effective OTC medications are available, codeine is now rarely used for this purpose. 

Medications containing less than 15 mg of codeine per single dose (most contain either 8 mg or 12 mg) are classified as Schedule V. Cough suppressants with codeine make up the majority of this category. Dmgs in Schedule V have a low potential for abuse, but abuse may lead to limited physical dependence and/or psychological dependence compared to drugs in Schedule IV. 

Many opiate analgesics are effective cough suppressants (also called anti-tussives), although only codeine and dihydrocodeine are generally used for this purpose. As there is a dissociation between the anti-tussive and analgesic action of the opiates, dextromethorphan and noscapine are now commonly used as cough suppressants because of their efficacy and lack of dependence-producing properties. 

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