Hello Fellow Steemians.
Welcome to my New post in health series where i will be talking about Important health issues .
The title of this says "Do not Give Opioid Cough and Cold Medicine to your Children under 18" . Well this was not my statement. FDA, The U.S drug and food administration has said it yesterday. The official statement is as follows:
After safety labeling changes are made, these products will no longer be indicated for use to treat cough in any pediatric population and will be labeled for use only in adults aged 18 years and older.
Labeling for the medications also is being updated with additional safety information for adult use – including an expanded Boxed Warning, the FDA’s most prominent warning ‒ notifying about the risks of misuse, abuse, addiction, overdose and death, and slowed or difficult breathing that can result from exposure to codeine or hydrocodone
In this post we will be learning about the Basics of Opioids, their role in Cough and Cold and Why FDA had to limit its use and What alternative Medicine can we use.
Opiods
Opioids, chemically are alkaloid drugs obtained from Papaver somniferum plant. These are widely used to relieve pain, mostly the pain which is not relieved by simple NSAIDs(Non steroidal anti inflammatory drugs) . They achieve this action by suppressing the pain centres in the Central Nervous System(Brain) and also altering the emotional components induced by pain(anxiety, fear, suffering).
Classification:
- Phenanthrene derivatives -
Natural- Morphine, Codeine
Semisynthetic- Hydrocodone, hydromorphone - Benzoisoquinoline - Papaverine, Noscapine
Opioids and Cough
Cough is a protective reflex which tries to expel the respiratory secretions, foreign bodies from the airway and keeps the air passage clean. When secretions and foreign particles irritate the air passage the sensory receptors are stimulated and they send information to the local centres and cough centres in brain .Typical sound in cough is produced by forceful expulsion of air against the glottis.
Although its a protective reflex prolonged and severe cough may cause serious hazards and also limits the social function of the individual . The health hazards may be
- Bleeding in the pharynx and larynx, Hernia, piles, Cardiac disease, Occular disorders
Cough Reflex(Image source)
Opioids are the antitussives drugs meaning that- they act in the central cough centres and increase the cough threshold. The important point to note is "Opioid do not treat the cause of cough they just supress it" so use of these should be limited only in Nonproductive cough(Cough where sputum is not produced, aka dry cough) or when it disturbs the daily activities.
The Main Opioids that are used in Medication of cough are Codeine and Hydrocodone. Common Combination and their brand names:
Fig- Common Opiod cough suppression cobinations(Image source)
Why FDA Has Acted Against the Use of These Drugs?
Opioids dont just have action on Cough centres only, they are central nervous system depressants and they also act on other systems too.
In central nervous system- they cause sedation, drowsiness, high dose cause depression of respiration fall in blood pressure. In the gastrointestinal tract they cause decreased gastric motility and constipation. But apart from these Opiod addiction or dependance is the most significant/problematic side effect and this is the reason why FDA had to limit its use.
Tolerance & Dependence Due to Opioid Cough suppressants
Prolonged or repeated use of opioids causes high degree of dependence and tolerance . Tolerance refers to the need of higher dose of drug in the subsequent prolonged use to elicit the therapeutic response .i.e. person requires higher dose of same drug in the future to relieve the same degree of symptoms . here is an example- lets suppose Person "x" requires 10 mg of the drug to relieve cough at present, if he uses this drug repeatedly over long time he will require more than 10 mg to relieve same degree of cough.
Dependance refers to the regular need of the drug in order to maintain daily acitivities.It is divied into physical and psychological dependence. Psychological dependence means person thinks he will not function well without use of the drug and physical dependence means person will develop abnormal side effect in case of stoppage of the drug.
Use of opioids iduce calming effect, lack of initiative, euphoria, mostly the addicts perceive pleasurable floating sensation. After repeated use for long time if person stops taking the drug he will develop withdrawl symptoms like- anxiety, restlessness, tremor, insomnia, palpitation and so on. so the person can not stop taking those drugs.
Addiction and children
Children are more vulnerable to dependence because of early age of exposure and there is also the high risk of overdose and death due to abuse.
In us and throughout the world the cough syrups(antitussives) are widely abused because of their easy availability as Over the Counter Drugs.
What are the alternative Drugs to Treat cough ?
cough and cold may occur as a allergic form seasonal change or simple viral cough which requires no treatment. Plenty of water and bed rest is helpful in this case. But if drug is to be used there are many non opioid medications available for cough.
- Non - opoid antitussives - noscapine, dextormethorphan
- Antihistamines- Chlorpheniramine, diphenhydramine, promethazine
- Mucolytics- Bromhexine, ambroxol, acetyl cystine
*This medical information is for educational purpose only, do not use it as a medical advice . For any health problem seek a direct professional help
That's all for today, today we learned something important about opioids and their dependance effect. Thanks for your time... if you have any queries feel free to write a comment, if you liked my work please upvote and resteem this post and follow 
References
1.https://www.medscape.com/viewarticle/891210
2.https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm592109.htm
3.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3931656/
4.https://weinberggroup.com/fda-news/fda-labeling-requirements-codeine-tramadol/
5.Essentials of medical pharmacology, 7th edition,KD Tripathi
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