Analgesia Opiates - Analgesia Opiates General Side Effects:...

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Analgesia Opiates General Side Effects: Constipation (can cause ileus) , N+V, respiratory depression and drowsiness, dry mouth, urinary retention anorexia, dependence (see below) General caution: reduced resp reserve (COPD/asthma), hypotension, hypothyroid, BPH, biliary tract disorders (all except pethidine contract sphinter of Oddi) CI: acute resp depression, acute abdomen, acute EtOH, raised ICP/head injury (resp depression causes CO2 retention, which causes vasodilation and worsens ICP), Heart failure secondary to chronic lung disease Interactions: MAOIs dont give within 2 weeks Codeine Weak opiate used for mild/moderate pain (Step 2 on WHO ladder) Dose/route: Oral 30-60mg up to max 240mg/24hrs Less in elderly or LF/RF. Has a 1/10 conversion with oral morphine e.g. 240mg of codeine (max dose) is equivalent to 24mg of oral morphine Side Effects/caution/Contraindications/interactions: As other opioids but less than morphine. Constipation main problem. Combined preparations: Co-codamol - codeine and paracetamol. Available in different strength preparations: 8/500 (8mg codeine/500mg paracetamol) = weak/standard version
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30/500 = more effective analgesia (15/500 also available so prescribe by dose!) Co-dydramol – dihydrocodeine and paracetamol. Usually 10/500 – max dose 8 tablets/24hrs e.g. 80mg of dihydrocodeine and 4g paracetamol. Tramadol
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Analgesia Opiates - Analgesia Opiates General Side Effects:...

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