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Created with Fabric.js 1.4.5 Loss of territories - productive land,industries and raw resources Tylenol 3 Brand Name: Tylenol 3®Generic: Codeine +APAPFunction: Pain Relief (DEA Sch 3)Route: Route Oral / tablet Codeine: - Narcotic/centrally acting analgesic.- Opioid agonist. Common Dosage Common Dosage Range Mechanism of Action Pharmacokinetics Regular-Release Distribution Extended-Release Absorption Metabolism - Codeine 15mg to 60 mg/Acetaminophen 300 mg to 1000 mg every 4 hours. - 24 hour dosage should not go over Codeine 360 mg/Acetaminophen 4000mg. - Almost absorbed entirely by GI tract.- Passive transport.- Bioavailability: 85% to 98%. - Plasma concentration: 10 to 90 minutes, ranges from 8 up to 32 µg/mL. - 650 mg caplet: 325 mg immediate release, 325 mg matrix formulation.- Plasma concentration: 30 mins to 3 hours, ranges from 6.9 to 14.1 µg/mL. - Distributed throughout most of the bodys fluids excluding fats.- Volume: 0.95 L/kg. - 10% to 25% of the drug binds to plasma proteins.- From intravascular spaces to different body tissues -liver, spleen and kidney. - Passes blood-brain barrier.- Does not aggregate in body tissues or bind to plasma proteins. AcetaminophenThrough liver by first-order kinetics and microsomal enzyme systems.3 pathways: a) conjugation with glucuronide b) conjugation with sulfate c) oxidation via the cytochrome80-85% conjugated principally with glucuronic acid4% metabolized to toxic metaboliteFurther detoxified by conjugation with glutathione Codeine Metabolized by liver 10% of given codeine becomes demethylated morphine Ultra-fast metabolism of morphine may lead to increased toxicity - 1 tablet of acetaminophen 300mg/codeine 30 mg or acetaminophen 650 mg/codeine 60mg every 4 hours PRN. Codeine:- Plasma half life: approximately 2.9 hours.- Most eliminated from kidney.- 90% passed through urine within 24 hours.- Remaining eliminated in feces. Excretion Acetaminophen:- Plasma half life: about 1.25 - 3 hours.- May be longer with certain conditions (liver damage).- Eliminated through liver metabolism (conjugation).- Renal excretion.- 85% of oral dose is excreted in the urine with 24 hours.- Remaining eliminated in feces. Special Populations Prescribe with caution to:- Special-Risk Patients: - Elderly, debilitated, severe impairment of renal or hepatic function - Head injuries, elevated intracranial pressure, acute abdominal conditions - Hyperthyroidism, urethral stricture, Addisons disease, prostatic hypertrophy - Individuals carrying genotype associated with ultra-rapid metabolism of codeineto morphine (1-7% Caucasians, 10-30% Ethiopian and Saudi Arabians).- Pregnant Women Acetaminophen: - Nonopioid.- Nonsalicylate analgesic. Indications - TYLENOL® with Codeine - Acetaminophen and Codeine phosphate- Tablets indicated for relief of mild to moderately severe pain. Contraindications - Hypersensitivity- Hepatitis or severe hepatic/renal impairment- Children who have undergone tonsillectomy and/or adenoidectomy (postoperative pain management) Warnings/Precautions Precautions:Important things to tell your doctor: - Allergy to acetaminophen, codeine, other narcotic pain medications (morphine) - History of brain disorders, breathing difficulties, kidney, gallbladder, or liver disease, mental/mood disorders, use/abuse of drugs/alcohol, stomach/intestinal issues, trouble urinating, pancreatitis.- May cause dizziness or drowsiness - Do not drive, use machinery, or participate in activities involving alertness.- Avoid alcoholic beverages.- Any condition requiring a limit/avoidance of substances in diet (diabetes, alcohol dependence, liver disease).- Greater sensitivity in older patients to the side effects of this drug.- Women who are pregnant or may become pregnant. Warnings- Head injury or other intracranial lesions- Narcotics also produce other CNS depressant effects- Hepatotoxicity- Serious Skin Reactions- Death Related to Ultra-Rapid Metabolism of Codeine to Morphine- Hypersensitivity/Anaphylaxis- Acute Abdominal Conditions- Abuse Potential- Sulfite Sensitivity Cost - 30 tablets of 300mg/30mg Generic Acetaminophen / Codeine: $8.14 - $13.30- 30 tablets of 300mg/30mg Brand Tylenol 3: $36.09 - $40.90
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