Codeine is an opioid pain-relieving with utilizes like those of morphine, but it is considerably less powerful as a pain relieving and has just mild narcotic impacts. Its essential site of activity is at the mu opioid receptors circulated all through the CNS. Codeine decreases intestinal motility through both a local and possibly central mechanism of action. Codeine smothers the cough reflex by a direct focal activity, most likely in the medulla or pons. Codeine and its salts are ingested from the gastrointestinal tract and beginning of pain-relieving activity happens 30 to 45 minutes after eating when given orally. Pinnacle impact is come to inside 1 to 2 hours and the term of pain relieving and antitussive activity is 4 hours and 4 to 6 hours individually.
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Pharmacokinetics of Codeine
Codeine is promptly consumed from the gastrointestinal tract and processed by O-and N-demethylation in the liver to morphine and norcodeine which with codeine are excreted entirely by the kidney, basically as conjugates with glucuronic acid. The greater part of the discharge items shows up in the pee inside 6 hours and 40 to 60 for every penny of the codeine is discharged free or conjugated, roughly 5 to 15 for every penny as free what's more, conjugated morphine and around 10 to 20 for each penny as free and conjugated norcodeine.
Indications for medicine
Codeine phosphate is shown for:
the relief of mild to moderate torment (including torment related to the terminal ailment, post-agent torment and cerebral pain),
the alleviation of the sign of diarrhea (aside from diarrhea caused by harming),
as an antitussive in the control of a non-beneficial cough
Codeine is especially significant for torment related to coughing.
Doses and administration of the Codeine
Codeine might be given orally in dosages of 15 mg to 60 mg up to 6 times each day for the alleviation of agony. If these dosages neglect to assuage torment, bigger dosages once in a while succeed and may offer ascent to anxiety and fervor. The most extreme suggested day by day dosage is 300 mg. For the non-productive hack, the typical doses are 10 mg to 20 mg each 4 to 6 hour to a most extreme aggregate of 120 mg in 24 hours.
Codeine ought to be utilized with caution in patients with the following conditions:
Adrenocortical inadequacy e.g. Addison's Disease
Impaired kidney/liver capacity
Recent gastrointestinal surgery
Gallbladder malady or annoy stones
Obstructive and provocative entrails infection – codeine diminishes peristalsis,
Reduced respiratory capacity or history of asthma
Urinary tract surgery
Patients taking monoamine oxidase inhibitors or within 14 days of ceasing such treatment
builds tone and division in the entrails and can raise the colonic weight