Hydrocodone chemical structure
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Vicoprofen

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. Sales and production of this drug have increased significantly in recent years, as have diversion and illicit use. more...

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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 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 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/clammy skin, sometimes bradycardia, and hypotension. A severe overdose may involve circulatory collapse, cardiac arrest and/or death.

Notes

  1. ^  Tarascon Pocket Pharmacopoeia.

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Drug challenge
From Nursing, 11/1/98 by Gever, Marcy Portnoff

You routinely administer combination drugs.. but do you know what's in them? To find out, match each combination of ingredients in Section II with its correct name in Section I.

SECTION I

1. Combivir (Glaxo Wellcome)

2. Vicoprofen (Knoll)

3. Apresazide 50/50 (Novartis)

4. Menogen (Breckenridge)

5. Vanex Forte-R (Schwarz Pharma)

SECTION II

a. esterified estrogen, 1.25 mg; methyltestosterone, 2.5 mg

This tablet may be prescribed to relieve the vasomotor symptoms of menopause. Esterified estrogen helps relieve hot flashes and vaginal dryness and reduces the risk of osteoporosis. Methyltestosterone, an androgen, relieves hot flashes. Tell your patient she may experience androgenrelated adverse reactions such as abnormal hair growth.

b. hydrocodone bitartrate, 7.5 mg; ibuprofen, 200 mg This tablet may be prescribed to control moderate to moderately severe pain. Hydrocodone bitartrate is an opioid analgesic. Ibuprofen, a nonsteroidal anti-inflammatory agent, is a nonopioid analgesic. Caution your patient against performing activities that require alertness.

c. chlorpheniramine maleate, 12 mg; phenylpropanolamine HCI, 75 mg

This extended-release capsule may be prescribed to control allergy symptoms. Chlorpheniramine maleate is a first-generation (sedating) antihistamine; phenylpropanolamine HCI is a decongestant. Warn your patient to avoid diet pills or other products containing phenylpropanolamine (PPA).

d. hydralazine, 50 mg; hydrochlorothiazide, SO mg This combination may be prescribed to control hypertension. Hydralazine is a peripheral-dilator antihypertensive; hydrochlorothiazide is a thiazide diuretic. Tell your patient to contact her physician if she experiences prolonged fatigue, fever, or pain in her muscles or joints; these symptoms may signal a lupuslike adverse reaction related to hydralazine.

e. lamivudine, 150 mg; zidovudine, 300 mg This tablet is indicated for treatment of HIV infection. Lamivudine, formerly known as 3TC, is a synthetic nucleoside analogue. Zidovudine, formerly known as AZT, is a pyrimidine nucleoside analogue. Tell your patient that this isn't a cure for HIV infection and she must continue taking it even if she feels well.

ANSWERS: 1e, 2b, 3d, 4a, 5c.

Copyright Springhouse Corporation Nov 1998
Provided by ProQuest Information and Learning Company. All rights Reserved

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