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- Pharmacology For Codeine + Ephedrine
Codeine + Ephedrine Pharmacology
Codeine + Ephedrine
About Codeine + EphedrineN/AMechanism of Action of Codeine + EphedrineN/APharmacokinets of Codeine + EphedrineN/AOnset of Action for Codeine + EphedrineN/ADuration of Action for Codeine + EphedrineN/AHalf Life of Codeine + EphedrineN/ASide Effects of Codeine + EphedrineN/AContra-indications of Codeine + EphedrineN/ASpecial Precautions while taking Codeine + EphedrineN/APregnancy Related InformationN/AOld Age Related InformationN/ABreast Feeding Related InformationN/AChildren Related InformationN/AIndications for Codeine + EphedrineN/AInteractions for Codeine + EphedrineN/ATypical Dosage for Codeine + EphedrineN/ASchedule of Codeine + EphedrineN/AStorage Requirements for Codeine + EphedrineN/AEffects of Missed Dosage of Codeine + EphedrineN/AEffects of Overdose of Codeine + EphedrineN/ACodeine
About CodeineAn opiate, methylmorphine , Narcotic analgesic, antitussive, and antidiarrheal.Mechanism of Action of CodeineCodeine exerts it`s action through opioid receptors and posses antitussive properties. It selectively and directly acts on cough centre and suppresses cough. It also posses analgesic action due to it`s agonistic action on opioid receptors.Pharmacokinets of CodeineAbsorption: Well absorbed after oral and parenteral administration. Distribution: Widely distributed in the body; it crosses placenta and also enters in to the breast milk. Metabolism: Metabolized in the liver by demethylation and glucuronide conjugation, Excretion: Excreted mainly in the urine as nor codeine and free and conjugated morphine.Onset of Action for CodeineOral: 30 to 45 minutes
I.V.: Rapid
I.M.: 10 to 30 minutes
S.C.: 10 to 30 minutes
Duration of Action for CodeineOral: 4 to 6 hours
I.V.: 4 to 6 hours
I.M.: 4 to 6 hours
S.C.: 4 to 6 hours
Half Life of CodeineN/ASide Effects of Codeine1. Constipation
2. Nausea
3. Vomiting
4. Drymouth
5. Respiratory depression
6. Hypotension
7. Bradycardia
8. Dizziness
9. Sedation
10. Euphoria
11. Urine retention
12. Flushing
13. Pruritus
14. Diaphoresis
15. Physical dependence.Contra-indications of Codeine1. Hypersensitivity to the drug
2. Bronchial asthma
3. Increased intracranial pressure
4. Respiratory depression
5. Paralytic ileus
6. Head injury
7. Alcoholism
8. Diverticulitis
9. Following bowel surgery.Special Precautions while taking Codeine1. Renal impairment
2. Hepatic impairment
3. Increased CSF pressure
4. Hypothyroidism
5. Addison`s disease
6. COPD
7. In deliberate individuals
8. Prostatic hypertrophy
9. Epilepsy
Pregnancy Related InformationContraindicatedOld Age Related InformationUse with cautionBreast Feeding Related InformationUse with cautionChildren Related InformationUse with cautionIndications for Codeine1. Nonproductive cough
2. Mild to moderate pain.Interactions for CodeineN/ATypical Dosage for CodeineAdults:
Oral:
Nonproductive cough:10 to 20mg 4 times daily;Maximum dose: 120mg/day
Oral, S.C., I.M.:
Mild to moderate pain:15 to 60mg Orally, S.C., or I.M.;4 to 6 times daily as required by the patient.
Children:
Oral:
Nonproductive cough:
Over 12 years: 10 to 20mg 4 times daily
Age 6 to 12: 5 to 10mg 4 times daily;Maximum dose: 60mg/day
Age 2 to 6: 1mg/kg/day as four equally divided doses and do not exceed 30mg in 24 hours.
Oral, S.C., I.M.:
Mild to moderate pain:0.5mg/kg orally every 4 to 6 hours or 0.5mg/kg S.C. or I.M.
Schedule of CodeineHStorage Requirements for CodeineStore at controlled room temperature at a range of 15 to 30 degree C and protects from light.Effects of Missed Dosage of CodeineTake the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.Effects of Overdose of CodeineEstablish adequate respiratory exchange via a patent airway and ventilation as needed. Administer opioid antagonist Naloxone to reverse respiratory depression use repeatedly as required. (Naloxone shouldn`t be administered unless patient has clinically significant respiratory or cardiovascular depression.). If patient shows signs and symptoms within 2 hours of ingestion empty the stomach by gastric lavage and induced emesis. Reduce absorption by administration of activated charcoal. Closely monitor vital parameters and correct fluid and electrolyte balance. Provide symptomatic and supportive treatment.Ephedrine
About EphedrineAlpha/Beta Adrenergic Agonist , Sympathomimetic amine, Stimulant, vasopressor(parenteral), bronchodilator.Mechanism of Action of EphedrineEphedrine is a mixed acting sympathomimetic drug which mainly acting indirectly but also has some direct action on alpha and beta adrenergic receptors. It causes release of nor-epinephrine from it`s storage sites and stimulates alpha and beta adrenergic receptors. It relaxes bronchial smooth muscle by stimulating beta-2 adrenergic receptors and thus causes increased vital capacity, relief of mild bronchospasm, improved air exchange and decreased residual volume. Ephedrine produces cardiac stimulation with increased systolic and diastolic pressure when nor-epinephrine stores aren`t depleted. It produces positive inotropic effects with low doses through action on beta-1 receptors in heart. It causes vasodilatation through beta-2 receptors and vasoconstriction through alpha adrenergic receptors. Presser effects results from vasoconstriction, cardiac stimulation, and increased cardiac output. It produces nasal decongestant action by stimulating alpha receptors in blood vessels of nasal mucosa and causing vasoconstriction and nasal decongestion.Pharmacokinets of EphedrineAbsorption: Well absorbed after Oral, S.C., or I.M. administration.
Distribution: Widely distributed throughout the body
Metabolism: Slowly metabolized in liver by oxidative deamination, demethylation, aromatic hydroxylation and conjugation.
Excretion: Excreted mainly through urine as unchanged drug.
Onset of Action for EphedrineOral: 15 to 60 minutes
I.V.: 5minutes
I.M., S.C.: 10 to 20 minutes
Duration of Action for EphedrineOral: 3 to 5 hours
I.V.: 60 minutes
I.M.: S.C.: 30 to 60 minutes
Half Life of EphedrineN/ASide Effects of Ephedrine1. Arrhythmias
2. Palpitations
3. Tachycardia
4. Hypertension
5. Precordial pain
6. Insomnia
7. Nervousness
8. Headahe
9. Dizziness
10. Confusion
11. Euphoria
12. Delirium
13. Mucosal irritation
14. Dry nose and throat
15. Nausea
16. Vomiting
17. Anorexia
18. Urine retention
19. Painful urination
20. Muscle weakness
21. Diaphoresis.
Contra-indications of Ephedrine1. Hypersensitivity to the drug or other sympathomimetics
2. Severe coronary artery disease
3. Porphyria
4. Arrhythmias
5. Angina pectoris
6. Susstatial organic heart disease
7. Cardiovascular diseases
8. Angle closure glaucoma
9. Psychoneurosis
10. In those taking MAO inhibitors
Special Precautions while taking Ephedrine1. Hypertension
2. Hyperthyroidism
3. Nervous or excitable states
4. Diabetes
5. Prostatic hyperplasia
6. Diabetes
Pregnancy Related InformationContraindicatedOld Age Related InformationUse with cautionBreast Feeding Related InformationContraindicatedChildren Related InformationUse with cautionIndications for Ephedrine1. As nasal decongestant
2. As bronchodilator
3. Acute severe bronchospasm
4. Hypotension
5. Enuresis
Interactions for EphedrineN/ATypical Dosage for EphedrineOral:
Adults:
As bronchodilator or nasal decongestant:12.5 to 50mg at every 3 to 4 hours; as required. Do not exceed 150mg in 24 hours.
Orthostatic hypotension: 25mg 1 to 4 times daily as required.
Children:
Above 12 years:12.5 to 50mg at every 3 to 4 hours; as required. Do not exceed 150mg in 24 hours.
Age 6 to 12: 6.25 to 12.5mg every four hours. Do not exceed 75mg in 24 hours.
Children over 2 years: 2 to 3mg/kg/day in 4 to 6 divided doses.
Orthostatic hypotension: 3mg/kg/day divided in to 4 to 6 doses.
Enuresis: 25 to 50mg at bed time.
Nasal spray:
As nasal decongestant:
Adults and children over 12 years: 2 to 3 sprays to each nostril; not more than every four hours.
Children (age 6 to 12): 1 to 2 sprays to each nostril; not more than every four hours.
I.M., S.C., or I.V.:
Acute severe bronchospasm: 12.5 to 25mg I.M., S.C., or I.V.
Hypotension:
Adults: 25 to 50mg S.C. or I.M., or 10 to 25mg as slow I.V. bolus. A second I.M. dose of 50mg or I.V. dose of 25mg is administered if required. Repeat I.V. doses in 5 to 10minutes if required.
Maximum dose: 150mg/day.
Children: 3mg/kg/day S.C. or I.V. divided in to 4 to 6 doses
Schedule of EphedrineN/AStorage Requirements for EphedrineStore at controlled room temperature at a range of 15 to 30 degree C. in a well closed container. Protect from light.Effects of Missed Dosage of EphedrineTake the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of EphedrineProvide supportive treatment and symptomatic measures. If patient is conscious induce emesis and reduce absorption by administration of activated charcoal. Perform gastric lavage if required. Maintain airway and blood pressure and closely monitor vital signs. Do not administer vasopressors. Beta blockers such as propranolol are used to treat arrhythmias. Use cardio selective beta blockers in asthmatic patients. Treat hypertension with Phentolamine, Seizures with paraldehyde or Diazepam, Pyrexia with seizures.
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