narcotic med question

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by RN always
Nov 25, '02   Views: 937   Comments: 5

  1. This is probably a really dumb question but I'm going to ask anyways. Do ALL narcotics have codeine in them? My patient told me that her doctor said that all narcotics do have codeine in them, thats why they all cause constipation. Does anyone know?
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    About RN always

    Joined: Nov '02; Posts: 346; Likes: 3
    staff nurse med/surg

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  3. by jdomep
    Nov 25, '02
    Joined: Sep '02; Posts: 281
    We just went over this in class (but if I listened correctly) I thought only the ones that prevent coughing have codeine?...
  4. by P_RN
    Nov 25, '02
    Occupation: RN-i (RETIRED) Specialty: ORTHOPAEDICS-CERTIFIED SINCE 89 ; From: US ; Joined: May '00; Posts: 14,479; Likes: 2,298
    No they don't all have codeine. The opiates morphine, codeine, etc have the potential for causing constipation. The synthetics Meperidine for example also have the same potential.
  5. by RN2B2005
    Nov 25, '02
    Occupation: Nursing student Joined: Nov '02; Posts: 389; Likes: 10
    The doctor may have been trying to simplify things for the patient, but no, not all narcotic medications have codeine in them. Codeine is just a member of the opiod derivative analgesic family, along with hydrocodone, dihydrocodeine, morphine, and others. Synthetic opioids like Demerol and Dilaudid can also cause constipation.

    For instance, loperamide HCl used to be a scheduled narcotic (called Lomotil), but is now sold over-the-counter as Imodium A-D. There's no codeine in Imodium A-D, but loperamide does cause constipation in large doses--and stops diarrhea in therapeutic doses.

    When my mother had diarrhea due to chemotherapy, she was treated with Imodium A-D...which was d/c'd when she was rx'd Dilaudid for pain, because the Dilaudid acted both as an analgesic and an anti-diarrheal.

    Hope this helps.
  6. by sanakruz
    Nov 25, '02
    Joined: Oct '02; Posts: 1,079; Likes: 53
    It's the anticholenergic affect of these meds that causes constipation. Many people are "allergic " to codeine because of the advese reactions they have experienced.
  7. by kmchugh
    Nov 25, '02
    Occupation: CRNA Joined: Mar '02; Posts: 2,000; Likes: 66
    While anticholinergics do have a constipating effect, narcotics do not have an anticholinergic effect. All narcotics are constipating, but this is due in large part to opioid receptors in the bowels, not due to anticholinergic effect. An anticholinergic effect by narcotics would also serve to raise heart rate, as with atropine.

    Kevin McHugh

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