CodeineBy: Jessica Jeffries

“I could get addicted to that.” -Kim

Isolated from Opium (agonist)

Metabolized to morphine (elicit analgesia)

Used to replace morphine (not thought to be addictive)

1960 Schedule II controlled substance

“Drug activation occurs when the CYP2D6 gene produces a hepatic drug-metabolizing enzyme, CYP2D6”(Kelly 322).

North Africans, Ethiopians, Saudi Arabians > Caucasian> African-Americans > Chinese or Japanese >Hispanics

Information

Metabolic Pathway•70% C6G•7% N-demethylation•5% O-demethylationCYP2D6•4% unchanged

•Liver, brain, intestine

Cough Suppressant due to mu

Mild-Moderate Pain reliever

19th century pain relief & diabetes control

Every 4-6 hours

Medical Uses

Purple Drank (sizzurp, lean syrup)

Starting Dose 30-60mg, settle at 250mg

Euphoria, elation, “liking”, analgesia

Dextromethorphan

Recreational Uses

Weak affinity for opioid mu-receptors

Relaxing “You’ll get high”-

Josh

Addictive Qualities

The Face of Addiction

http://www.parentdish.ca/2014/04/21/kids-health-codeine-study/

Itching, constipation, dizziness, sedation, flushing, nausea, vomiting, and hives

Respiratory CNS Seizures Cardiac Arrest Increases pain sensitivity (TLR4)

Side Effects

Endorphin production decreased

Tolerance Withdrawal

Opioid Poisoning Coma Pinpoint Pupils Respiratory

Depression

Toxicity/Deaths

Burns, Jarrett M, and Edward W Boyer. “Antitussives and Substance Abuse.”Substance Abuse and Rehabilitation 4 (2013): 75–82. PMC. Web. 21 Nov. 2014.

"Central And Peripheral Mechanisms Of Narcotic Antitussives: Codeine-Sensitive And -Resistant Coughs." (2007): OAIster. Web. 21 Nov. 2014.

"Cough Syrup Abuse: It's The Codeine." Alcoholism & Drug Abuse Weekly 26.4 (2014): 3-4. Academic Search Premier. Web. 21 Nov. 2014.

"Drug." Equianalgesic Chart (Changes in Italics). Web. 21 Nov. 2014. <http://www.healthcare.uiowa.edu/familymedicine/fpinfo/Docs/adultopioidrefguide.htm>.

Johnson, J L, et al. "Codeine-Induced Hyperalgesia And Allodynia: Investigating The Role Of Glial Activation." Translational Psychiatry 4.(2014): e482. MEDLINE. Web. 21 Nov. 2014.

Kelly, Patricia, A. "Pharmacogenomics: Why Standard Codeine Doses Can Have Serious Toxicities Or No Therapeutic Effect." Oncology Nursing Forum 40.4 (2013): 322-324. CINAHL Complete. Web. 21 Nov. 2014.

Lam, Jessica, et al. "Codeine-Related Deaths: The Role Of Pharmacogenetics And Drug Interactions." Forensic Science International 239.(2014): 50-56. Academic Search Premier. Web. 21 Nov. 2014.

Schwartz, Jason J., PhD. "Codeine." Salem Press Encyclopedia Of Health (2012): Research Starters. Web. 20 Nov. 2014

Sources