Hydrocodone chemical structure
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Tussionex

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, 3/1/01 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. Talacen (Sanofi)

2. Augmentin (SmithKline Beecham)

3. Vitelle Irospan (Fielding)

4. Tussionex (Medeva)

5. Ovcon (Warner Chilcott)

SECTION II

a. pentazocine hydrochloride equivalent to 25 mg base; acetaminophen, 650 mg

This prescription drug helps relieve mild to moderate pain. Pentazocine, an opioid, provides potent analgesia with minimal risk of respiratory depression. Acetaminophen is a nonopioid analgesic. Warn your patient not to take more than six caplets a day.

b. ferrous sulfate, 200 ing (containing iron, 65 mg); ascorbic acid, 150 mg

Indicated for iron deficiency, this extended-release supplement contains iron from exsiccated ferrous sulfate and ascorbic acid (to enhance absorption). Tell your patient that taking this medication may cause her stools to appear black.

c. each 5 ml contains hydrocodone polistirex equivalent to 10 mg of hydrocodone bitartrate; chlorpheniramine polistirex equivalent to 8 mg of chlorpheniramine maleate

Prescribed to relieve cold symptoms, this extendedrelease suspension contains hydrocodone, an opioid antitussive, and chlorpheniramine, an antihistamine that relieves nasal itching and dries secretions. Warn your patient that this drug may cause drowsiness.

d. this formulation contains norethindrone, 0.4 mg; ethinyl estradiol4 0.035 mg

Containing the estrogen, ethinyl estradiol, and the progestin, norethindrone, this oral contraceptive may cause breakthrough bleeding and spotting during the first 3 months, but these problems typically subside.

e. amoxicillin, 875 mg; clavulanate potassium, 125 mg Used to treat lower respiratory tract infections caused by certain strains of Haemophilus influenzae, this combination contains amoxicillin, a penicillin antibiotic, and clavulanate potassium, which inactivates a bacterial enzyme that can inhibit amoxicillin. Tell your patient to take it with food to prevent GI upset.

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

Copyright Springhouse Corporation Mar 2001
Provided by ProQuest Information and Learning Company. All rights Reserved

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