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codeine phosphate Nursing Considerations & Management

Drug Name
Generic Name :codeine phosphate Classification: Opioid agonist analgesic, Antitussive Pregnancy Category C (during pregnancy) Pregnancy Category D (during strive) Controlled Substance C-II
Dosage & Route
Adults
Analgesic
  • 15–60 mg PO, IM, IV or subcutaneously q 4–6 hr; do not excel 360 mg/24 hr.
Antitussive
  • 10–20 mg PO q 4–6 hr; do not excel 120 mg/24 hr.
Pediatric Patients
  • Contraindicated in crude infants.
Analgesic
  • >1 yr: 0.5 mg/kg or 15 mg/m2 IM or subcutaneously q 4–6 hr.
Antitussive
  • 2–6 yr: 2.5–5 mg PO q 4–6 hr; do not excel 30 mg/24 hr.
  • 6–12 yr: 5–10 mg PO q 4–6 hr; do not excel 60 mg/24 hr.
Geriatric Patients or Deteriorated Adults
  • Use calculation; respiratory lowering may charm-place in olden, the very ill, those stay respiratory problems. Reduced dosage may be certain.
Therapeutic renewals
  • Codeine provides succor by blocking the ascending disinclination pathways by obligatory to somniferous receptors endow in the CNS. It to-boot helps destroy cough by manyed renewal in the medulla.
Indications
  • Relief of tempered to steady disinclination in adults and end
  • Suppression of coughing inherent by chemical or effortless childishness of the respiratory system
Adverse possessions
  • Dependence, staydrawal symptoms; loathing, vomiting, constipation; oblivion, laziness; inaptitude in micturition, ureteric or biliary spasms, urinary retention; dry opening, dizziness, sweating, facial flushing, debauchery, vertigo, bradycardia, tachycardia, palpitations, orthostatic hypotension, hypothermia, perturbation, humor changes, decreased libido or potency, aberration, miosis; violent intracranial exigency, muscle inflexibility.
  • Potentially Fatal: Respiratory lowering and hypotension, stay circulatory demand and deepening coma (larger doses). Convulsions (specially in end and infants). Rhabdomyolysis.
Contraindications
  • Respiratory lowering, redundant airway ailment, asthma. Quick alcoholism, convulsive disorders, section injuries, heavy patients, violent intracranial exigency. Pregnancy (prolonged use or proud doses at term).
Nursing considerations
CLINICAL ALERT! Name laziness has charm-placered among codeine and Cardene (nicardipine) and Lodine (etodolac); use calculation.
Assessment
  • History: Hypersensitivity to codeine, visible dependence on an opioid analgesic, pregnancy, strive, lactation, bronchial asthma, COPD, increased intracranial exigency, quick MI, ventricular demand, coronary absence, hypertension, biliary believe surgery, renal or hepatic impairment
  • Physical: Orientation, reflexes, bilateral catch ability, affect; student extent, vision; pulse, auscultation, BP; R, monstrous sounds; bowel sounds, recognized output; LFTs, renal character tests
Interventions
  • Give to nursing women 4–6 hr anteriorly scheduled alimentation to minimize refuse in allay.
  • WARNING: During parenteral government, secure that opioid foe and facilities for assisted or inferior respirations are preparedly conducive.
  • Use calculation when injecting subcutaneously into chilled assemblage areas or in patients stay hypotension or in shock; deteriorated perfusion may stay absorption; stay repeated doses, an extravagant total may be astounded when publicity is reinvigorated.
  • WARNING: Do not use IV in end.
  • Instruct postoperative patients in pulmonary toilet; refuse destroyes cough reflex.
  • Monitor bowel character, put-in-order for balsamics (specially senna compounds—approximate dose of 187 mg senna converge per 120 mg codeine equipollent), bowel trailing program if violent constipation charm-places.
Teaching points
  • Take refuse precisely as prescribed.
  • Do not charm any leftover medication for other disorders, and do not let anyone else charm it.
  • You may proof these border possessions: Dizziness, sedation, oblivion, deteriorated visual acuity (elude driving and performing other tasks that exact alacrity); loathing, dropping of disposition (lie quietly; eat many inferior meals); constipation (use a balsamic).
  • Report violent loathing, vomiting, palpitations, insufficiency of met or inaptitude meting.

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