Psychology

Codeine

General description of Codeine

Analgesia (pain alleviation) is a basically used to improve patients' quality of life and enhancing their capacity in their participation of day to day chores. To alleviate pain, the drug was first approved by the FDA in the United States in 1950. It does so without disrupting consciousness or affecting other senses in any way. The poppy plant, Papaver somniferum, is the source of opiates like (Codeine Olashore et al., 2018). Codeine is used for conditions that cause chronic coughing and as a hypnotic, antiperistaltic, sedative, and antinociceptive drug among its many uses.

Indication

Codeine sulfate is one of the most regularly prescribed dosage forms. It is an opioid analgesic available in tablet form and is approved to treat mild to moderate to severe pain (Allen & Ansel, 2013). Adults over 18 may take the solution form as a cough suppressant, either on its own or in combination with other medications.

Associated conditions: Upper respiratory symptoms, Cough, mild pain, Flu brought about by influenza, dry cough, pain severe pain, moderate pain, and common cold (Allen & Ansel, 2013).

Associated treatments: Clearing the airways of mucus.

Contraindications: Prevent life-threatening side effects of medications.

General effects

Codeine, like hydrocodone and morphine, is a cough suppressant and mild narcotic pain reliever. Even a tiny dose of codeine taken orally may be transformed to morphine in the body's metabolic pathways. Codeine reduces pain by increasing the body's tolerance to it (Codeine Olashore et al., 2018). Additionally, codeine produces sedation, sleepiness, and decreased breathing.

Antitussive activity

In clinical studies, this medication has shown antitussive effects and has helped treat tuberculosis-related cough and sleeplessness caused by coughing (Birring et al., 2019). The cough nucleus in the medulla is directly affected by codeine, which reduces the cough reflex.

Intestinal motility effects

According to Goelen et al. (2020), codeine as Analgesia can minimize intestinal motility in two ways: locally and centrally. Constipation is a possibility as a result of this. Obstructive bowel disease may be caused by chronic opioid use, especially for patients with intestinal symptoms.

Effects on CNS (Central Nervous System)

Codeine phosphate has similar uses to morphine, but it has a much lower analgesic potency. The mu-opioid receptors, found within the CNS, are the primary site of action. Codeine's sedative properties are not as strong as morphine's (Birring et al., 2019). The drug can however lead to respiratory system anxiety through activation of -opioid receptors in the CNS at specific locations.

Blood pressure effects: There is an amplified risk of blood pressure stability being disrupted by peripheral ischemia and other causes while using this medication.

Mechanism of action

Codeine's affinity for the mu opioid receptor is a bit weaker compared to morphine. Codeine's analgesic effects are believed to be the result of the drug's conversion to Morphine, but the exact mechanism by which it works is still a mystery (Mattia & Coluzzi, 2015).

Absorption: The gastrointestinal system is responsible for the absorption of codeine. The peak plasma levels happen 60 minutes after the administration of drugs.

Steady-state concentration: It only takes 48 hours after administering 15 mg of codeine sulfate each 4 hours taken consecutively for 5 days to achieve steady-state levels of it.

Volume of distribution: When 3-6 L/kg is administered it shows an extensive drug distribution into the tissues.

Metabolism

It is estimated that around 70- 80 percent of the consumed amount of the drug is processed in the liver. Most of it is converted to codeine-6 glucuronide (C6G), and the remainder is converted to morphine and norcodeine.  2B7 and 2B4 are the primary UDP-glucuronosyltransferase (UGT) enzymes involved in the glucuronidation of codeine to the intermediate codeine 6 glucuronide, a psychoactive substance.  Among the key enzymes involved in the transformation of codeine into morphine is cytochrome P450 2D6, whereas P450 3A4 is the most important enzyme involved in converting codeine to norcodeine is cytochrome P450 3A4. Glucuronic acid is subsequently conjugated with opioids and norcodeine, which results in additional metabolization. There are two glucuronide metabolites of mo


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