Hydrocodone/paracetamol , also known as hydrocodone/acetaminophen or hydrocodone/APAP and marketed under the trademark Vicodin and < b> Norco among others, is a combination of opioid pain medication, hydrocodone, with paracetamol (acetaminophen). It is used as a prescription drug to relieve moderate to severe pain. It exists in tablets, potions, and solutions in various strengths for oral administration.
It can be addictive and easy to overdose.
Video Hydrocodone/paracetamol
Usage
Medical
Hydrocodone/acetaminophen is a two-material combination formula consisting of opioid hydrocodone and non-opioid analgesic acetaminophen. This is indicated for the relief of moderate to severe pain in acute, chronic, or postoperative types. Hydrocodone/acetaminophen present in oral solution and tablet formulation; But the strength of each component can vary. In October 2014, the Drug Enforcement Administration rescheduled the combination hydrocodine drug from Schedule III to Schedule II because of its risks for abuse, abuse, and diversion.
Recreation
Hydrocodone transfer and recreational use have increased in recent years due to its opioid effects. In 2009 and 2010, hydrocodone was the second most commonly seen opioid drug in drug evidence submitted to federal, state and local federal forensic laboratories as reported by the National Forensic Laboratory Information System (NFLIS) and DEA Systems for Taking Information from Proof of Drug (STEP).
Pregnancy and breastfeeding
Category of pregnancy C: The risks to pregnancy can not be excluded. Animal-controlled studies have not been done with this drug.
Low acetaminophen concentrations are excreted through breast milk, but the excretion of the hydrolysis is unknown.
Kidney and liver disorders
Use with caution because of possible risks of toxicity.
Maps Hydrocodone/paracetamol
Side effects
Most common
- Lightheadedness
- Dizzy
- Euphoria
- Sedasi
- Nausea and vomiting
- Headaches
Less common
- Central nervous system: drowsiness, confusion, lethargy, anxiety, fear, discomfort, psychic dependence, mood swings, decreased mental and physical performance
- Gastrointestinal system: constipation
- Genitourinary system: inability to urinate, bladder spasms
- Respiratory depression: inadequate breath
- Special senses: hearing loss, permanent hearing loss
- Dermatology: rash, itching
* The exact prevalence (%) is unknown
Black box warning
"Acetaminophen has been associated with cases of acute liver failure, occasionally resulting in liver transplantation and death.Most cases of liver injury are associated with the use of acetaminophen at doses that exceed 4000 milligrams per day, and often involve more than one product containing acetaminophen.
Allergy warning
"Do not eat hydrolysine and acetaminophen bitartrates if you are allergic to any of the ingredients.If you develop signs of allergies such as rash or breathing difficulties, stop using hydrolysine bitartrates and acetaminophen tablets and get in touch with your health care provider immediately."
Overdose
Hydrocodone: Respiratory depression, extreme somnolence progresses to coma, muscle limpness, cold and moist skin, slow heartbeat, low blood pressure, sudden loss of heart function, and death can occur.
Acetaminophen: Liver and renal failure, low blood coma may occur.
Interactions
Hydrocodone/acetaminophen may show an increased respiratory depression effect when combined with other sedatives such as other opioids, benzodiazepines, nonbenzodiazepine sedatives, psychotropic drugs, and anticonvulsants.
Concomitant use of alcoholic products may increase the risk of acute liver failure.
Monitoring
Laboratory function tests should be used to monitor therapy in people with severe liver or kidney disease.
Pharmacology
Hydrocodone
- Mechanism of action: Hydrocodone acts mainly on mu-opioid receptors, but is also a weak agonist against opioid opioid receptors and kappa delta.
- Absorption/distribution: Oral formulations can be absorbed from the gastrointestinal tract and remain 20-50% bound to plasma proteins. The onset of analgesia is about 20 to 30 minutes with a duration of 4 to 8 hours and t 1/2 of 3 to 4 hours.
- Metabolism/excretion: It is metabolized to norhydrocodone by cytochrome P450 3A4 and to hydromorphone, also biologically active, by cytochrome P450 2D6. For individuals who have defects in the CYP2D6 coding gene, lower drug clearance and less metabolites such as hydromorphone will form; However, the effect on analgesia remains unknown.
Acetaminophen
- Mechanism of action: Acetaminophen acts to inhibit the COX enzyme, which is responsible for the synthesis of prostaglandins. Prostaglandins improve the perception of pain. Inhibition of prostaglandin production helps to relieve pain.
- Absorption/distribution: Oral acetaminophen half-life is 1.25 to 3 hours and peak levels are achieved by 10-60 minutes after ingestion. Metabolism/excretion: Acetaminophen is metabolized primarily in the liver via glucuronidation and sulfation to non-toxic metabolites and some highly reactive metabolites, which are inactivated by glutathione. 85% of oral doses are excreted renally. At high doses, the supply of glutathione can not meet its demand, resulting in the accumulation of highly reactive compounds leading to liver damage.
Society and culture
In May 2017, professional golfer Tiger Woods was arrested by police for driving under the influence. Woods says that this is because of the four prescription drugs he uses for back surgery, one of which is Vicodin.
Rule
On 30 June 2009, an FDA advisory panel for Food and Drug Administration voted with a narrow margin to advise the FDA to remove Vicodin and other opioids, Percocet, from the market because "it is likely to overdose from prescription drugs and acetaminophen products". The panel also mentioned concerns of liver damage from their acetaminophen component, which is also a key ingredient in commonly used non-receptive drugs such as Tylenol. Every year, acetaminophen overdose is associated with about 400 deaths and 42,000 hospitalizations.
In January 2011, the FDA asked manufacturers of prescription combination products containing acetaminophen to limit the amount of acetaminophen to no more than 325mg in each tablet or capsule within 3 years. The FDA also requires manufacturers on all products containing acetaminophen to issue a black box warning indicating potential risks for severe liver injury and a warning that highlights the potential for allergic reactions.
On 22 August 2014, the Drug Enforcement Administration (DEA) announced that all hydrocodine combination products (HCP) will be rescheduled from Schedule III to Schedule II of the Controlled Substance Act (CSA), effective October 6, 2014. In 2010, more of 16,000 deaths were associated with abuse of opioid drugs. Although there is a legitimate medical use for HCP, the data indicates that a large number of individuals abused HCP.
Popular culture
Vicodin is mentioned in songs such as Eminem's "Kill You", Blackbear's "Sniffing Vicodin in Paris", Kendrick Lamar "ADHD", Future's "Lay Up", "Mural" Lupe Fiasco, Queens of the Stone Age "Feel Good Hit from Summer ", A Winged Victory for the Sullen" Steep Hills Of Vicodin Tears "and The Wombat '" Give Me a Try ". The use of Vicodin is a central theme in the 2004-2012 medical TV drama House , in which the main character of Dr. Gregory House is addicted.
Brand name
Brand names include Adol among others.
See also
- Hydrocodone/aspirin
- Hydrocodone/ibuprofen
- Oxycodone/paracetamol
References
External links
- Vicodin US Drug Schedule DEA
- Federal Vicodin U.S.
- US. National Drug Library: Drug Information Portal - Vicodin
Source of the article : Wikipedia
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