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Discussion

Why codeine for a subdural hematoma??

Hello all. I am doing a case study on a 28 yr old female with an acute subural hematoma. She has a history of seizures but they are well controlled with her medication.

It states that the neurosurgeon prescribes Codeine IV for pain.

The question is: why does the neurosurgeon prescribe Codeine?

Any thoughts are appreciated. Thanks!

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    The Dr. would not want to perscribe anything for pain that could mask neuro status. Hope that helps :)

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    The Dr. would not want to perscribe anything for pain that could mask neuro status. Hope that helps :)

    This, because then you can't properly assess them and if the patient is sedated from medication, that basically invalidates your neuro exam.

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    I'm just a beginning student, but my first thought was that morphine and demoral can increase intracranial pressure so that class of drugs would not be used for head injuries. Don't know if that would be a contraindication to subdural hematomas or not, but its something you could look into.

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    Codeine is an opiate drug, not as strong as morphine but similar to hydrocodone (the opiate in vicoden). It can cause the same side effects as any other opiate, so prescribing codeine is really more of a Physicians preference than anything, making it an odd choice in this patient since codeine has been known to cause seizures, particularly when given IV.

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