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opium

Tincture of opium. DEA controlled substance. Class 2. Indications: 1) symptomatic treatment of diarrhea 2) relief from pain Contraindications: 1) increased intracranial pressure 2) severe respiratory depression 3) severe liver or renal insufficiency Dosage: (contains 25X more morphine than paragoric) 1) 0.6 mL = 6 mg of morphine 2) 0.3-1 mL QID PRN 3) daily dosage should not exceed 6 mL Liquid: Opium tincture: 10% (4 oz bottles) Pharmacokinetics: 1) metabolized by the liver 2) metabolites excreted in the urine Adverse effects: 1) common (> 10%) - palpitations, hypotension, bradycardia, drowsiness, dizziness, weakness 2) less common (1-10%) - restlessness, headache, malaise, decreased urination, histamine release 3) 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 4) in usual anti-diarrheal dosages, opium does NOT result in analgesia or euphoria Drug interactions: 1) CNS depressants 2) tricyclic antidepressants 3) may potentiate effects of morphine & other opiate agonists 5) phenothiazines may antagonize effects of opiates Mechanism of action: 1) increases smooth muscle tone of GI tract 2) inhibits GI motility 3) diminishes digestive secretions

Related

belladonna/opium (B & O supprettes) paregoric

General

antidiarrheal agent opiate pharmacologic combination

References

  1. Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998 - not on National VA formulary
  2. Kaiser Permanente Northern California Regional Drug Formulary, 1998

Component-of

belladonna alkaloid/opium belladonna/opium (B & O supprettes)