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At least 631 records · Page 35Linked to original sources
PubMed1998

Solitary rectal ulcer induced by excessive use of analgesic suppositories containing paracetamol, caffeine, and codeine.

We report the case of a 53-yr-old woman who developed an ulcer of the distal rectum with mild stenosis after prolonged use of suppositories containing paracetamol, caffeine, and codeine. After undergoing extensive diagnostic tests with exclusion of other possible causes, she admitted to the abuse of the suppositories. She was treated with frequent endoscopic balloon dilations to prevent progression of the rectal stenosis. Because of severe pain on defecation, she needed a protective colostomy which could be closed after the healing of the ulcer 7 months later. There was no significant residual stenosis. This case is compared to cases described in the past 30 years.

Acetaminophen↗
PubMed1999

Transformations of codeine to important semisynthetic opiate derivatives by Pseudomonas putida m10.

A biotransformation mixture which contained codeine and washed cells of Pseudomonas putida M10 gave rise to a number of transformation products that are of clinical importance which included hydrocodone, dihydrocodeine and 14beta-hydroxycodeine. Incubations with the same organism and codeinone gave rise to 14beta-hydroxycodeinone and 14beta-hydroxycodeine. Cell-free extracts and membrane fractions of P. putida M10 were shown to catalyse the 14beta-hydroxylation of codeinone. In addition, the potent analgesic oxycodone was shown to be produced from 14beta-hydroxycodeinone.

Alcohol Oxidoreductases↗
PubMed1997

Neonatal abstinence syndrome due to codeine.

The neonatal abstinence syndrome (NAS) is a potentially life threatening illness associated with significant morbidity especially in the neonatal period. A case of NAS due to codeine prescribed for pain relief during pregnancy is reported. Clinicians should be aware that narcotic derivatives prescribed in late pregnancy can give rise to this type of problem.

Acetaminophen↗
PubMed1981

A double-blind comparison of ibuprofen, ASA-codeine-caffeine compound and placebo in the treatment of dental surgery pain.

A double-blind randomized clinical trial was conducted in eighty-seven patients with mild, moderate or severe dental surgery pain to evaluate the analgesic activity of a single dose of the following compounds: (i) ibuprofen 400 mg, (ii) ACC-30 (a compound containing ASA 375 mg; codeine phosphate 30 mg; caffeine citrate 30 mg), (iii) placebo. Ibuprofen was significantly better than ACC-30 and placebo on almost all pain intensity, degree of relief and duration of analgesia parameters. ACC-30 was not significantly different from placebo on any analgesic measurement. No serious side-effects were reported with any of the study medications.

Adult↗
PubMed2000

Variable cytochrome P450 2D6 expression and metabolism of codeine and other opioid prodrugs: implications for the Australian anaesthetist.

Codeine is a popular opioid prodrug dependent on the activity of the specific cytochrome P450 enzyme 2D6 (CYP2D6). This enzyme catalyses the production of the potent analgesic metabolite morphine, but genetic studies have demonstrated that individuals from different ethnic groups exhibit considerable variability in the functional capacities of their expressed CYP2D6 enzymes, and pharmacological studies have shown many commonly prescribed drugs can reduce the action of CYP2D6 enzymes. These findings have significant clinical implications for the rational prescription of effective analgesia, especially in a multicultural country like Australia.

Analgesics, Opioid↗
PubMed1997

Comparison of the efficacy of paracetamol versus paracetamol, codeine and promethazine (Painstop) for premedication and analgesia for myringotomy in children.

This prospective double-blinded study compared the analgesic effectiveness and incidence of complications of a compound preparation Painstop (Paedpharm Pty Ltd) containing paracetamol 12 mg, codeine 0.5 mg and promethazine 0.65 mg per 1.0 ml, dosage 1.0 ml/kg, with paracetamol 20 mg/kg. Ninety-five children aged 1 to 12 years, ASA 1-2, scheduled for myringotomy and drain tuber insertion as a day procedure were randomized to receive Painstop or paracetamol 30 to 60 minutes prior to surgery. Preoperative drowsiness and complications on induction and postoperative sedation, pain and times to achieve goals were recorded. The groups were comparable for age, gender, weight, anaesthetic technique and duration of surgery. Times to eye opening (P = 0.05) and first oral intake (P = 0.006) were significantly longer in the Painstop group. There was, however, no difference in times to discharge. Late sedation was more common in the Painstop group (P = 0.03). Pain scores were low and similar in both groups and the need for additional analgesia was uncommon.

Acetaminophen↗
PubMed1983

Paracetamol overdose: protective effect of concomitantly ingested antimuscarinic drugs and codeine.

Twelve cases of paracetamol overdose are reported. Nine patients ingested antimuscarinic agents and/or codeine concomitantly. Our findings indicate that 'mixed' overdose of this type gives rise to marked attenuation of the rate of paracetamol absorption and, apparently, reduced morbidity associated with paracetamol poisoning. It is speculated that suitable antimuscarinic agents may be incorporated into paracetamol formulations to achieve inhibition of gastric emptying and to confer a degree of protection in case of overdose.

Acetaminophen↗
PubMed1983

A suspected case of codeine-induced erythema multiforme.

Erythema multiforme usually presents as an acute inflammatory reaction involving the skin and mucous membranes. Systemic symptoms and organ involvement also can occur. The disease is associated with many illnesses and drugs. A two-year-old child presented to the Family Practice Center with a probable codeine-induced episode of erythema multiforme. The patient had been treated with Actifed-C Expectorant for a suspected viral upper respiratory tract infection. The rash was characteristic of erythema multiforme, but there was no involvement of mucous membranes. The rash quickly abated after the discontinuation of the drug and the administration of hydroxyzine. A viral cause for the rash could not be ruled out. When erythema multiforme is precipitated by a particular drug, discontinuation of the offending agent is necessary. The rash should disappear quickly. Adjunctive use of antihistamines may offer some benefit for the patient. Systemic corticosteroids may be necessary for more severe cases.

Child, Preschool↗
PubMed1997

A comparison of etodolac (Ultradol) with acetaminophen plus codeine (Tylenol #3) in controlling post-surgical pain in vasectomy patients.

The efficacy and safety of etodolac (Ultradol) and acetaminophen plus codeine [A + C (Tylenol #3)] in controlling post-surgical pain were compared in an open-label, randomized, parallel-group outpatient study. Patients who were voluntarily having a vasectomy performed for sterilization were assigned to receive either etodolac 200 mg (20 patients) or A + C (20 patients). All medication was taken as required for up to 7 days. Efficacy assessments were made at 1, 6 and 24 hours after surgery and included pain measurement (Likert Visual Analogue scale), patient and physician global assessments and time to analgesic relief. Safety assessments were made throughout the study and included vital signs and adverse event monitoring. Results of the study indicated that patients taking etodolac were more likely to say they could return to work 24 hours after their vasectomy (p = 0.04). There were no other statistically significant differences between the two groups of patients. The results from this study indicate that etodolac and A + C are equally efficacious and well-tolerated for the control of post-vasectomy pain and that patients may observe an increased benefit with etodolac by being able to return to work sooner.

Acetaminophen↗
PubMed1999

Codeine intoxication in the neonate.

Although opiates can provide patients with relief from pain and the discomfort of cough, the routine prescription of these drugs for infants demands caution and concern. Infants, particularly neonates, are not merely small adults requiring smaller dosages, but rather uniquely different patients. Neonates present with an immature physiology and biochemistry with respect to drug metabolism. We report a case of codeine intoxication in the neonate, in which the drug was prescribed for cough control during an emergency department visit.

Codeine↗
PubMed2003

Beliefs and social norms about codeine and promethazine hydrochloride cough syrup (CPHCS) onset and perceived addiction among urban Houstonian adolescents: an addiction trend in the city of lean.

In the current study, we used a qualitative approach to investigate relevant beliefs and norms associated with codeine and promethazine hydrochloride cough syrup (CPHCS) consumption, initiation, and perceived addiction among 48 alternative school students who identified themselves as current CPHCS users. In general, both boys and girls believed that CPHCS addiction started during an individual's initial consumption. A majority of both groups reported that their second CPHCS event was initiated during the same or next day after their first event. Our findings suggest that friends and an innovative form of hip-hop music called "screw" are strong reinforcers of CPHCS use.

Adolescent↗
PubMed1997

Pattern of self-administered paracetamol and codeine analgesic consumption after mandibular third-molar surgery.

Pattern of analgesic consumption after unilateral mandibular third-molar surgery was investigated in an open study in 201 patients. All patients were supplied with six analgesic tablets containing 500 mg paracetamol and 30 mg codeine. Instructions for use were given. A mean consumption of 4.9 tablets over the 1st week and 3.6 tablets the day of operation was found. Eight (4%) patients indicated inadequate or no effect of the medication. The remaining patients were able to control pain, to a level of one-third of maximum pain, by using from one to five tablets. One hundred and thirty-two (68%) patients followed instructions with regard to start of medication. No difference in mean tablet consumption was found between compliant patients and those who delayed the intake of the first analgesic dose by more than 1 h. Predictor analysis showed the most powerful predictors to be preoperative depth of the third molar and moderate or heavy smoking. Thirteen per cent explanatory power of all predictors together was found.

Acetaminophen↗
PubMed1998

Mania associated with codeine and paracetamol.

OBJECTIVE: We describe a patient in whom a manic episode was precipitated by use of panadeine forte, a preparation containing codeine and paracetamol. CLINICAL PICTURE: The patient developed a discrete manic psychotic episode. TREATMENT: The treatment consisted of cessation of the Panadeine forte and antipsychotic medication. OUTCOME: The patient made a complete recovery after 1 week. CONCLUSIONS: Mania can be induced by large doses of Panadeine forte, particularly if there is a biological predisposition.

Acetaminophen↗
PubMedDate not supplied

The association of preexisting psychosocial pathology with deaths involving propoxyphene or codeine.

The study utilized a sample of 94 propoxyphene- (Darvon) and codeine-related deaths that had occurred in Los Angeles County within a 1-year period (during 1979-1980). Data describing these deaths were obtained from the records of the Los Angeles County Medical Examiner's Office and from interviews with informants who had know the deceased subjects. The findings revealed the presence of extensive psychosocial pathology. High levels of prior drug abuse involving both prescription and illicit drugs were reported. Other findings included a markedly high incidence of prior drug overdoses, arrests, psychiatric disorders, interpersonal conflicts, and prior suicide attempts.

Adult↗
PubMed1999

Subtypes of codeine cough syrup abusers.

This paper highlights the abuse potential of the codeine containing cough syrups, which may take two forms. One, experimental abuse in school or college students which later persists in a dependent pattern. Two, pre-existing opioid abusers, as a substitute which starts after the school or college years. The short term treatment outcome is better in the former group in that they are able to maintain abstinence for a relatively longer period.

Adolescent↗