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Dihydrocodeine

Dihydrocodeine, also called DHC or DF-118, is a synthetic opioid analgesic prescribed for postoperative pain, severe dyspnea, or as an antitussive. It was developed in the early 1900s, and is similar in chemical structure and pharmaceutical behaviour to codeine, but is approximately twice as potent. It has approximately 30% the potency of IM morphine. more...

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Although dihydrocodeine does have extremely active metabolites, in the form of dihydromorphine and dihydromorphine-6-glucuronide (100x more potent), these metabolites are produced in such small amount that they do not have clinically important effects².

Indications

Approved indication for dihydrocodeine is the management of moderate to severe pain. It is usually formulated as tablets containing 30 mg with one tablet taken every 4-6 hours when necessary.

Dihydrocodeine is sometimes marketed in combination preparations with paracetamol (acetaminophen) as co-dydramol (BAN) to provide greater pain relief than either agent used singly (q.v. Drug Synergy).

Side Effects

As with other opioids, tolerance and physical and psychological dependence develop with repeated dihydrocodeine use. All opioids can impair the mental and/or physical abilities required for the performance of potentially hazardous tasks such as driving or operating machinery if taken in large doses, but have the opposite effect in moderate doses .

Regulation

In the USA, it is a DEA Schedule II substance, although preparations containing small amounts of dihydrocodeine are classified as Schedule III or Schedule V, depending on the concentration of dihydrocodeine relative to other active constituents, such as acetaminophen.

In the United Kingdom dihydrocodeine is a Class B drug - making it (in principle) more dangerous than cannabis which is a class C drug. Illegal possession of dihydrocodeine can result in up to 5 years in prison and/or an unlimited fine.

Read more at Wikipedia.org

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Drug challenge
From Nursing, 10/1/00 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. Dimetane-DX (A.H. Robins)

2. Neosporin + Pain Relief (Warner-Lambert)

3. GoLYTELY (Braintree)

4. Premphase (Wyeth-Ayerst)

5. DHC Plus (Purdue Frederick)

SECTION II

a. conjugated estrogen, 0.625 mg; medroxyprogesterone acetate, 5 mg The tablets taken on days 1 to 14 in this hormone replacement therapy contain conjugated estrogens. Those taken on days 15 to 28 contain conjugated estrogens and the progestin medroxyprogesterone. Ten your patient she may have menstrual-like bleeding or spotting. b. one 4-liter jug contains polyethylene glycol (PEG) 3350, 236 g; sodium sulfate, 22.74 g; sodium bicarbonate, 6.74 g; sodium chloride, 5.86 g; potassium chloride, 2.97 A Used to clean the bowel for colonoscopy, this solution contains PEG and the electrolytes sodium sulfate, sodium bicar bonate, sodium chloride, and potassium chloride, which induce diarrhea by an osmotic effect. Tell the patient not to eat solids for at least 2 hours before starting the solution. c. each 5 ml contains dextromethorphan hydrobromide, 10 mg; pseudoephedrine hydrochloride, 30 mg; brompheniramine maleate, 2 mg

A health care provider may prescribe this syrup to relieve cold symptoms. Dextromethorphan is a nonopioid cough suppressant; pseudoephedrine, a sympathomimetic, relieves nasal congestion. Brompheniramine, an antihistamine, relieves itchy eyes, nose, and palate. Warn your patient to use caution during activities that require mental alertness.

d. dihydrocodeine bitartrate,16 mg; acetaminophen, 356.4 mg; caffeine, 30 mg Prescribed to manage pain, these capsules contain dihydrocodeine, an opioid analgesic, and acetaminophen, a nonopioid analgesic. Caffeine may enhance their effects: Warn your patient to avoid alcohol while taking this drug. e. bacitracin zinc, 500 units; neomycin, 3.5 mg; polymyxin B sulfate, 10,000 units; pramoxine hydrochloride,10 mg A patient may select this over-the-counter ointment to treat cuts or wounds. Bacitracin, neomycin, and polymyxin B are antibiotics; pramoxine, a topical anesthetic. Tell your patient to keep this ointment away from her eyes.

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

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