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Dihydrocodeine tartrate.

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VOL: 101, ISSUE: 18, PAGE NO: 29

Generic/proprietary names


Generic/proprietary names
- Dihydrocodeine tartrate (tablets, oral solution, injection, cough syrup).



- DF118 (tablets).



- DHC Continus (modified-release tablets).



- Also an ingredient in some compound preparations.



- Legal: prescription-only medicine (tablets, oral solution); controlled drug (injection).



- Functional: narcotic analgesic.



Chemical: opioid.



- Narcotic analgesic acting on opiate receptors in the central nervous system. Inhibits pain pathways, increasing pain threshold and lessening the perception of pain.



- Moderate to severe pain.



- Syrup for suppressing cough in palliative care.






- Respiratory depression.



- Head injury.



- Raised intracranial pressure.



- Acute alcoholism.



- Risk of paralytic ileus.



- History of drug misuse.



- Asthma.



- Pregnancy, childbirth, lactation.



- Hypothyroidism.



- Hypotension.



- Renal impairment.



- Liver damage.



- Consider reducing dose for older or debilitated patients.



- Dihydrocodeine is not recommended for children under four years; DF118 and DHC Continus are not recommended for any children.



- Respiratory depression.



- Cough suppression.



- Exacerbation/precipitation of asthma.



- Drowsiness.



- Hallucinations.



- Altered mood.



- Nausea, vomiting (particularly in early stages).



- Constipation.



- Gastric irritation.



- Anorexia.



- Cramps.



- Dry mouth.



- Hypotension.



- Hypothermia.



- Palpitations.



- Bradycardia.



- Urinary retention.



- Tolerance, dependence.



- Decreased libido.



- Risk of hypertensive crisis with monoamine oxidase inhibitors (MAOIs) or within 21 days of stopping them.



- Increased effects of hypnotics, other central nervous system depressants and alcohol.



Nursing considerations
- Assess pain to determine dosage, vital signs, level of consciousness, fluid balance.



- Administer with or after food, with anti-emetic if necessary.



- Provide fibre and fluids if patient becomes constipated.



- Evaluate the need for additional analgesics and the therapeutic response.



- Treatment of overdose: gastric lavage, intravenous naloxone, supportive treatment.



Patient teaching
- If affected by dizziness or drowsiness, do not drive or operate machinery.



- Take with food.



- Avoid alcohol.



- Explain possible side-effects and potential for dependence.



Nurses should refer to manufacturer’s summary of product characteristics and to appropriate local guidelines

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