This is my Vodcast assessment on Codeine. Enjoy
Hi mate cody p dean he is 21 years old six-foot and a healthy 70 kilos recently cody’s wisdom teeth have been giving him a bit of trouble so he’s gone to the dentist to get them removed cody was prescribed panadeine forte for the pain it contains 500 milligrams paracetamol and 30 milligrams codeine phosphate he was told to take 2 tablets every 4 hours at a maximum
Of 8 tablets per day but cody’s been wondering what is pain well the international association for the study of pain defines it as an unpleasant sensory and emotional experience associated with actual or potential tissue damage in addition there are four definitions that cody must acknowledge firstly the pain threshold is the point beyond which a stimulus can cause
Pain as well as pain tolerance the highest intensity of painful stimulation that a person is able to tolerate of particular relevance to cody’s pain are the definitions of a ladonia & hyperalgesia allodynia is pain due to a stimulus that does not normally provoke pain and hyperalgesia is increased pain from a stimulus that normally provokes pain there are also
Extraneous factors that affect pain in cody’s case these will most likely be sleep or lack of sleep discomfort and isolation as he recovers from the operation he has just received pharmacokinetics absorption cody’s medication is uncoded tablets taken orally after ingestion 90% of the drug is absorbed in the gastrointestinal tract and sent to the liver metabolism
Codeine is a pro drug and is metabolized in the liver by two subsets of cytochrome p450 2d6 and 3 a 4 into 2 more lipophilic metabolites 10% of the codeine is metabolized into morphine which has high opioid activity and is highly lipophilic the other metabolite is north codeine which has little opioid activity some people including 5% of white europeans like our
Ultra-rapid metabolizers this means that they produce more morphine given the same amount of coding as someone with a regular metabolism distribution the volume of distribution for codeine is approximately 3.5 liters per kilogram and approximately seven to twenty five percent of codeine is bound to plasma proteins in the blood codeine has a half-life of two and
A half to three hours the morphine that is produced in the metabolism of codeine is able to cross the blood-brain barrier due to its highly lipophilic properties excretion coenen appears in the urine approximately six hours after ingestion and 90% of the drug will be excreted within 24 hours the pharmacodynamics of codeine the metabolite morphine is an opioid
Full agonist it binds to mu kappa and delta receptors these receptors belong to the g coupled protein receptors family in the diagram we can see that the drug binds to g receptors in the extracellular fluid the g receptor crosses through the lipid bilayer and binds to g protein in the intracellular fluid this g protein inhibits adenylate cyclase which results in
Decreased ca mp this does two things first it closes calcium ion channels this decreases the number of neurotransmitters that are released secondly it opens potassium ion channels this results in a decrease in neural excitability this results in an inhibition of sensory transmission and alters the perception of pain pharmacological effects of codeine judah cody’s
Post-operative pain codeine was prescribed for its analgesic effects however cody may also experience the following sedation or drowsiness euphoria and or respiratory depression judah cody’s ultra rapid metabolism resulting in an increase in morphine cody may experience heightened effects compared to a regular user of codeine the issue with codeine in australia a
Rhys study by the medical journal of australia in 2015 highlighted that codeine related deaths increased from 3.5 per million in 2000 to 8.7 per million in 2009 interestingly accidental overdoses accounted for 48 point 8 percent of the total deaths and were increasing at nine point three percent per year the study also highlighted that those with substance abuse
Problems and chronic pain were more likely to overdose accidentally this could be due to two things firstly dependence dependence can be defined as drug seeking behavior despite a lack of therapeutic indication and despite adverse effects this is the result of neuroplastic changes in the brain which are particularly prominent in those with substance use disorders
And this can also lead to addiction the second aspect more likely to be involved in those with chronic pain is that of tolerance tolerance can be defined as repeated doses resulting in a lesson defect as a result a higher dose is needed to attain the desired effect however a higher dose can also come with an increased risk of adverse effects which include death the
Study by mj a noted that those with chronic pain may have been taking codeine in addition to already prescribed pain medications they may have also been compounding doses that is having one dose of codeine not receiving the desired effect due to tolerance and then taking another dose of codeine in a bid to receive that effect however in doing so they have increased
Their peak plasma concentration well above the therapeutic window into toxic levels this can lead to increased adverse effects which could include a possible overdose and death an alternative for cody cody is experiencing acute nociceptive pain accompanied by some initial post-operative inflammation due to his age and good health cody could instead benefit from
A paracetamol ibuprofen combination studies in america by the american dental association show that this combination has similar jaesik effects while having less adverse effects how you feelin cody you know what my i feel great good on you mate you
Transcribed from video
Codeine By Jerome Love
