Find information on thousands of medical conditions and prescription drugs.

Lortab

Hydrocodone or dihydrocodeinone (marketed as Vicodin, Anexsia, Dicodid, Hycodan, Hycomine, Lorcet, Lortab, Norco, Tussionex, Vicoprofen) is an opioid derived from either of the naturally occurring opiates codeine or thebaine. Hydrocodone is an orally active narcotic analgesic and antitussive. The typical therapeutic dose of 5 to 10 mg is pharmacologically equivalent to 30 to 60 mg of oral codeine. more...

Home

Lamisil

Lantus

Lariam

Larotid

Lasix

Lescol

Leucine

Levitra

Levora

Levoxyl

Levulan

Lexapro

Lexiva

Librium

Lidopen

Lipidil

Lipitor

Lithane

Lodine

Lomotil

Lortab

Lotrel

Lovenox

LSD

Lupron

Luvox

Luxiq

Theophylline

Sales and production of this drug have increased significantly in recent years, as have diversion and illicit use. Hydrocodone is commonly available in tablet, capsule and syrup form.

As a narcotic, hydrocodone relieves pain by binding to opioid receptors in the brain and spinal cord. It may be taken with or without food, but should never be combined with alcohol. It may interact with monoamine oxidase inhibitors, as well as other drugs that cause drowsiness. It is in FDA pregnancy category C: its effect on an unborn embryo or fetus is not clearly known and pregnant women should consult their physicians before taking it. Common side effects include dizziness, lightheadedness, nausea, drowsiness, euphoria, vomiting, and constipation. Some less common side effects are allergic reaction, blood disorders, changes in mood, mental fogginess, anxiety, lethargy, difficulty urinating, spasm of the ureter, irregular or depressed respiration and rash.

Hydrocodone can be habit-forming, and can lead to physical and psychological addiction. In the U.S., pure hydrocodone and forms containing more than 15 mg per dosage unit are called hydrocodone compounds and are considered Schedule II drugs. Those containing less than 15 mg per dosage unit are Schedule III drugs. Hydrocodone is typically found in combination with other drugs such as paracetamol (acetaminophen), aspirin, ibuprofen and homatropine methylbromide. In the UK it is listed as a Class A drug under the Misuse of Drugs Act 1971.

The presence of acetaminophen in hydrocodone-containing products deters many drug users from taking excessive amounts. However, some users will get around this by extracting a portion of the acetaminophen using hot/cold water, taking advantage of the water-soluble element of the drug. It is not uncommon for addicts to have liver problems from taking excessive amounts of acetaminophen over a long period of time--taking 10–15 grams of acetaminophen in a period of 24 hours typically results in severe hepatotoxicity. It is this factor that leads many addicts to use only single entity opiates such as OxyContin.

Symptoms of hydrocodone overdosage include respiratory depression, extreme somnolence, coma, stupor, cold and/or clammy skin, sometimes bradycardia, and hypotension. A severe overdose may involve circulatory collapse, cardiac arrest and/or death.

How Supplied

Notes

^ Tarascon Pocket Pharmacopoeia.

Read more at Wikipedia.org

• [List your site here Free!]

Administering acetaminophen safely
From Nursing, 11/1/03 by Acello, Barbara

QUESTION: Several of my patients who are taking acetaminophen for pain or fever have orders for other drug combinations containing acetaminophen. Should I be concerned about toxicity?

ANSWER: Yes. In the United States, acetaminophen toxicity is the second most common cause of liver failure leading to the need for liver transplant.

The maximum daily dosage of acetaminophen for adults is 4 grams. Drugs such as Darvocet-N 100, Lortab, Lorcet, Vicodin, Midrin, Duradrin, Roxilox, and Percocet contain 325 to 750 mg of acetaminophen per tablet. If your patient is receiving one of these drugs plus acetaminophen for mild pain or fever, you need to make sure his total daily acetaminophen dose doesn't exceed 4 grams. (For children under age 11, the maximum dose is 90 mg/kg/day. For chronic use and in some elderly patients, the daily dosage shouldn't exceed 3 grams.)

Before giving an acetaminophen preparation to any patient, review his medical record and ask about over-the-counter medications he's taking. (Many cold preparations, for example, include acetaminophen.) Toxicity can occur in any setting, but be extra vigilant if you work in home health care, long-term care, or chronic care because patients can self-medicate. If you discover that a patient is taking more than 4 grams/day of acetaminophen, notify the patient's primary care provider and document your communication.

Teach the patient that in the case of acetaminophen (and many over-the-counter medications), more isn't better. Teach him to read labels and identify acetaminophen in combination medications. If you work in a long-term-care setting, ask the pharmacist to identify all medications containing acetaminophen. Place an alert on the patient's medication administration record to remind colleagues about the potential for acetaminophen overdose and list special warnings on the patient's care plan. Another option is to ask the prescriber to review the patient's medications to determine if some containing acetaminophen can be eliminated or substituted.

Acetaminophen is rapidly absorbed from the gastrointestinal tract. Toxicity may occur from a single dose as low as 7.5 grams, or from repeated ingestion of doses greater than 4 grams/day. Liver damage has been reported in adults taking daily dosages as low as 6 grams. Doses of 5 to 8 grams/day over 2 to 3 weeks may also cause liver failure.

Certain drug interactions increase the dangers of acetaminophen use:

* Chronic, excessive alcohol consumption may increase the risk of acetaminophen-induced liver toxicity.

* Anticonvulsants, such as phenytoin, that induce hepatic microsomal enzymes may trigger acetaminophen-related liver toxicity by increasing conversion of acetaminophen to hepatotoxic metabolites.

* Isoniazid given with acetaminophen can increase the risk of hepatotoxicity.

* The effects of oral anticoagulants may be potentiated by chronic ingestion of large doses of acetaminophen.

Someone who develops acetaminophen toxicity may be asymptomatic or have anorexia, mild nausea, and vomiting. Several days later, she may develop right upper abdominal quadrant tenderness, jaundice, and other signs of liver involvement.

N-acetylcysteine, the antidote for acetaminophen toxicity, is most effective if given within 8 hours of acetaminophen ingestion, but can be given 24 hours or later after ingestion, depending on the patient's lab values. The time of acetaminophen ingestion may be difficult to establish, especially if the patient took the medication over hours or days. Super-activated charcoal should be given, if available; activated charcoal will absorb acetaminophen within 4 hours of ingestion.

Emetics aren't recommended because they delay administration of activated charcoal and reduce the patient's ability to tolerate oral n-acetylcysteine. N-acetylcysteine can be given I.V. if the patient can't tolerate oral medication.

SELECTED REFERENCE

Losch, P.: "Acetaminophen Toxicity," Kentucky Board of Pharmacy News, December 2000, http://www.ncbop.org/jan01-2.asp.

BY BARBARA ACELLO, RN, MSN

Barbara Acello is an independent nurse-consultant specializing in geriatrics and long-term care, a writer, and an educator. She lives in Denton, Tex.

Return to Lortab

Home

Contact

Resources

Exchange Links

ebay