What Are the Signs of a Hydrocodone Overdose?

Paracetamol hydrocodone tablets, the indication is suitable for relieving moderate to severe pain.

Drug Name: Paracetamol Hydrocodone Tablets

Drug type: prescription

Paracetamol hydrocodone tablet ingredients

This product is a compound preparation, its components are: dihydrocodeinone tartrate, each tablet contains 5mg; acetaminophen, each tablet contains 500mg.
The molecular formula is: C ₁₈ H ₂₁ NO ₃ C ₄ H ₆ O ₆ H ₂₀ and molecular weight: 494.50
The molecular formula is: C ₈ H ₁₉ NO ₂ and the molecular weight is 151.16

Paracetamol Hydrocodone Tablet Properties

This product is a capsule-shaped white tablet.

Paracetamol hydrocodone tablets indications

Suitable for relieving moderate to severe pain.

Paracetamol and hydrocodone tablets

The dose should be adjusted based on the patient's pain level and their response to the drug. However, it should be clear that if the medication is continued, the body will become resistant to dihydrocodeinone, and the occurrence of adverse reactions is dose-dependent. The usual dosage for adults is 1 to 2 tablets every 4 to 6 hours to achieve analgesic effects. The total dosage for 24 hours should not exceed 5 tablets.

Adverse Reactions of Paracetamol Hydrocodone Tablets

Common adverse reactions include dizziness, sedation, and nausea and vomiting. These reactions are more pronounced in ambulatory patients than in ambulatory patients, and some of the adverse reactions can be alleviated when the patient is in the supine position. Other adverse reactions include:
Central nervous system: lethargy, mental obscurity, mental and physical impairment, anxiety, fear, irritability, mental dependence and emotional changes.
Gastrointestinal system: antiemetic phenothiazine drugs can effectively inhibit the nausea and vomiting reactions that may occur after using this product; some phenothiazine derivatives can counteract the analgesic effect of this product, so the amount of anesthetic must be increased to ensure Its analgesic effect; while other phenothiazines can enhance the analgesic effect of the anesthetic, and reduce the amount of anesthetic used to achieve the analgesic effect. Long-term use of this product can cause constipation.
Urogenital system: ureteral spasm, bladder sphincter spasm, and urinary retention have been reported.
Respiratory depression: Dihydrocodeinone acts directly on the brainstem respiratory center, producing dose-dependent respiratory depression. Dihydrocodeinone also acts on the respiratory rhythm regulating center, causing irregular or periodic breathing. When significant respiratory depression occurs, it can be treated with the antagonist naloxone hydrochloride and symptomatic supportive treatment if necessary. Skin: rash, itching of the skin.

Paracetamol hydrocodone tablets contraindications

Those who are allergic to acetaminophen or dihydrocodeinone are contraindicated.

Precautions for Paracetamol Hydrocodone Tablets

This product is under the control of relevant narcotic drug management measures. Repeated use of anesthetics can cause mental dependence, physical dependence, and drug tolerance, so caution should be exercised in the prescription and administration of this product. But short-term use of this product for analgesia will not cause mental dependence. Physical dependence refers to a physical condition in which withdrawal must be continued to prevent withdrawal symptoms. After a few days of anesthesia therapy, some slight physical dependence may occur, but only with continuous use of anesthetic drugs for several weeks can there be clinically significant physical dependence. Drug tolerance refers to a state in which the amount of anesthetic must be continuously increased to achieve the same analgesic effect. At first it appears as a reduction in the analgesic time of the anesthetic, followed by a reduction in the analgesic effect. The incidence of drug tolerance varies from patient to patient.

Paracetamol hydrocodone tablets for pregnant and lactating women

Use during pregnancy: Teratogenicity: Experiments show that 700 times the human dose of dihydrocodeinone has teratogenic effects on hamsters. There is currently no comprehensive and well-controlled study of this product in pregnant women. Only when the expected benefit outweighs the risk to the fetus can Navara be used during pregnancy.
Non-teratogenic: If a pregnant woman takes opioids regularly before childbirth, her baby can be physically dependent. The main withdrawal symptoms are: irritability and crying, tremor, hyperreflexia, increased breathing rate, increased stool, sneezing, yawning, vomiting, and fever. The severity of infant symptoms is not necessarily related to the length and dose of opioids taken by the mother. At present, there is no uniform optimal treatment method for infant withdrawal symptoms. We recommend the following treatment regimen: chlorpromazine 0.7 to 1.0 mg / kg, given every 6 hours and compound camphor tincture 2 to 4 drops / kg, every 4 Give once every hour. The course of treatment is 4 to 28 days, and gradually decreases as the symptoms decrease.
Childbirth: Like all other anaesthetics, maternal use of resistant but short-term before delivery can cause neonatal respiratory depression to varying degrees. This is especially true when used in large doses.
Nursing women: A small amount of acetaminophen is secreted through milk, but the extent of its effect on infants is unknown. It is unclear whether dihydrocodeinone can be secreted by human milk. Many drugs can be secreted by breast milk. Breastfeeding mothers have the potential to have serious adverse effects on their babies, and sometimes the drugs are important to the mother. Therefore, when deciding whether to stop or stop breastfeeding, consider both factor.

Paracetamol hydrocodone tablets for children

The safety and effectiveness of this product for children has not been determined.

Paracetamol hydrocodone tablets for elderly

Special attention should be given to the elderly when they use any anesthetic (including resistant to keto). Watch closely for possible respiratory depression and common precautions.

Paracetamol hydrocodone tablets drug interactions

When used in combination with other narcotic analgesics, antipsychotics, anxiolytics or other central nervous system inhibitors (including alcohol), this product will produce a superimposed central nervous system inhibitory effect. When treatment requires a combination of drugs, the dose of one or all of the drugs should be reduced. The combination of dihydrocodeinone preparations with monoamine oxidase inhibitors or tricyclic antidepressants enhances both effects. Dihydrocodeinone can cause paralytic intestinal obstruction when used in combination with anticholinergic drugs.
Drug / Laboratory Interactions: Paracetamol can cause a urine urine 5-indoleacetic acid test to give a false positive response.
Respiratory Suppression: When used in large doses or for people who are allergic to this product, the drug may directly affect the respiratory stem of the brain stem, which may cause dose-related respiratory depression. Dihydrocodeinone can also act on the respiratory rhythm regulation center, causing irregular breathing or periodic breathing.
Craniocerebral injury and increased intracranial pressure: When there is a craniocerebral injury, other intracranial lesions, or an increase in intrinsic intracranial pressure, the respiratory inhibitory effect of the anesthetic and the increased intracranial pressure will increase. In addition, the use of anesthetics can mask the clinical course of patients with craniocerebral injury.
Acute abdomen: The use of anesthetics can mask the clinical course of acute abdomen and delay the diagnosis.
Patients with special risks: Aged patients, severely impaired liver and kidney function, hypothyroidism, Addison's disease, benign prostatic hyperplasia, and urethral strictures must be used with any anaesthetic analgesic (including resistant and acceptable) pay attention. Watch closely for possible respiratory depression and common precautions.
Patients need to know: high-risk tasks such as driving and machine operation require special mental and physical abilities. Like any anesthetic, resistance and possible damage to this area of operation ability, so you should pay attention accordingly.
When alcohol and other central system inhibitors are used in combination with tolerant, they can produce a central inhibitory effect. Therefore, the combined use of the two should be avoided.
Dihydrocodeinone is addictive. Therefore, when using this product, patients should take the dose prescribed by the doctor, and should not exceed the frequency of use prescribed by the prescription.
Laboratory examination: Patients with severe liver and kidney disease should regularly check liver and kidney function when taking this product.
Cough reflex: Dihydrocodeinone inhibits cough reflex, so patients with postoperative or respiratory disease should be cautious with all anaesthetics including resistant to legume.

Paracetamol hydrocodone tablets overdose

Acetaminophen:
Symptoms and signs: The most serious adverse reaction of acute acetaminophen overdose is liver necrosis, which may be fatal. In addition, tubular necrosis, hypoglycemic coma, and thrombocytopenia can also occur.
Rare reports of hepatic necrosis in patients with acute overdose of acetaminophen below 10 grams, or death caused by acute overdose of below 15 grams. Children are more tolerant than adults of liver poisoning caused by acute acetaminophen overdose. Regardless of whether adults or children suspect or have taken excessive amounts of acetaminophen, the following treatment measures should be taken as soon as possible.
If you take a dose of acetaminophen that may cause liver toxicity, the early symptoms are: nausea, vomiting, sweating, and general discomfort. Usually after 48 to 72 hours of overdose, clinical and laboratory examinations show obvious liver toxicity.
Treatment: Immediate gastric lavage or introduction of spit root syrup to promote vomiting to promote gastric emptying. Do not believe the patient's self-reported amount of overdose. Once suspected, the patient should be tested for serum acetaminophen as soon as possible; however, the test should not be earlier than 4 hours after taking the drug. In addition, liver function tests were performed early and rechecked every 24 hours.
Give N-acetylcysteine as an antidote as early as possible. It works best within 16 hours, but it should not exceed 24 hours at the latest. After the patient recovered, there was no residue in the body, and no abnormalities in the structure and function of the liver remained.
Dihydrocodeinone: Symptoms and signs: Typical clinical manifestations of severe overdose of dihydrocodeinone are respiratory depression (reduction in breathing rate and / or tidal volume, Chen-Shi breathing and cyanosis), extreme sleepiness and even coma, bone Muscle relaxation and damp and cold skin are sometimes accompanied by bradycardia and hypotension. Severe overdose can cause apnea, circulatory failure, cardiac arrest, and even death.
Treatment: First and foremost, reestablish sufficient gas exchange by establishing an unobstructed airway and using assisted or controlled ventilation. Naloxone hydrochloride is a specific antidote to respiratory depression caused by an overdose of anesthetics such as dihydrocodeinone or allergies to anesthetics. Therefore, it is best to administer an appropriate dose of naloxone hydrochloride intravenously, accompanied by respiratory resuscitation. Since the action time of dihydrocodeinone is longer than that of naloxone hydrochloride, patients should be kept under close observation during treatment, and the antagonist naloxone hydrochloride should be repeatedly administered to maintain adequate breathing.
Neither naloxone hydrochloride should be used if there is no clinically significant respiratory and cardiovascular depression. If necessary, oxygen can be given, intravenous fluids, vasodilators and other auxiliary treatments.
Gastric emptying can effectively remove unabsorbed residual drugs.

Paracetamol Hydrocodone Tablets Pharmacology and Toxicology

Dihydrocodeinone is a semi-synthetic anesthetic, analgesic, and antitussive drug. It has a variety of activities similar to the codeine properties. Most of these effects are related to the central nervous system and smooth muscle. It is currently believed that the mechanism of action of dihydrocodeinone and other opioids may be related to central opioid receptors. In addition to analgesics, narcotics can cause drowsiness, mood changes, and mental haze.
Paracetamol has central and peripheral analgesic effects, but the specific mechanism of action is unknown. Its antipyretic effect is by acting on the hypothalamic body temperature regulating center. Paracetamol inhibits prostaglandin synthetase, and has little effect on the cardiovascular and respiratory system at the therapeutic dose, but can cause circulatory failure and shallow breathing at toxic doses.

Pharmacokinetics of Paracetamol Hydrocodone Tablets

The pharmacokinetic behavior of a single ingredient is described below:
Dihydrocodeinone: Five male healthy volunteers took 10 mg of dihydrocodeinone orally and reached the maximum serum drug concentration in 1.3 ± 0.3 hours with an average peak concentration of 23.6 ± 5.2ng / ml and a half-life of 3.8 ± 0.3 hours . Dihydrocodeinone has a complex metabolic pathway, including reduction of O-desmethyl, N-desmethyl and 6-keto groups to 6-alpha or 6-beta hydroxyl metabolites.
Paracetamol: Paracetamol is rapidly absorbed through the gastrointestinal tract and is distributed in most tissues. Plasma half-life is 1.25 to 3 hours, which can increase when liver function is impaired or overdose. Paracetamol is eliminated (combined) mainly by the liver and excreted by the kidneys. 24 hours after oral administration of this product, about 85% are excreted in the urine. The excretion form is mainly glucuronic acid conjugates, and a small part is other forms of conjugates and originals.

Paracetamol Hydrocodone Tablets Storage

Store in the dark at 15-30 ° C. Keep out of reach of children.

Paracetamol Hydrocodone Tablet Packaging

Packaging specifications: 30 tablets / bottle, 100 tablets / bottle; packaging material: polyethylene plastic bottle.

Validity of Paracetamol Hydrocodone Tablets

Two years. ^[1]