opium
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Introduction
Tincture of opium. DEA controlled substance. Class 2.
Indications
- symptomatic treatment of diarrhea
- relief from pain
Contraindications
- increased intracranial pressure
- severe respiratory depression
- severe liver or renal insufficiency
Dosage
(contains 25X more morphine than paragoric)
Liquid: Opium tincture: 10% (4 oz bottles)
Pharmacokinetics
- metabolized by the liver
- metabolites excreted in the urine
Adverse effects
- common (> 10%)
- less common (1-10%)
- restlessness, headache, malaise, decreased urination, histamine release
- uncommon (< 1%)
- peripheral vasodilation, CNS depression, increased intracranial pressure, insomnia, mental depression, nausea/vomiting, constipation, anorexia, epigastric cramps, biliary tract spasm, urinary tract spasm, miosis, respiratory depression, physical & psychologic dependence
- in usual anti-diarrheal dosages, opium does NOT result in analgesia or euphoria
Drug interactions
- CNS depressants
- tricyclic antidepressants
- may potentiate effects of morphine & other opiate agonists
- phenothiazines may antagonize effects of opiates
Mechanism of action
- increases smooth muscle tone of GI tract
- inhibits GI motility
- diminishes digestive secretions