Opium Mixture Mixture No' I

1
Opium Mixture (Mixture No. I)

• ????????????????

2
????????? Opium Mixture
?????????????????????????????????????????????????
??? ??.?????? ?????????

• ???????????????????????
• Rx
• Opium Tincture 10 500 ml
• Potassium bromide 500 gm
• Chloral hydrate 500 gm
• Ethyl alcohol 95 500 ml
• Purified water to 15,000 ml

15 drops 15 grains 15 grains Chlorform water to
30 ml
3
Potassium bromide (KBr)

• CNS-depressant
• Anticonvulsant with sedative effects
• Use
• - Sedative-hypnotic (obsolescent)
• - Anti-seizure medication for dogs and cats.
• - USFDA not approved for use in human to
  control seizure. Only in German is approved.
• Dose 1-6 gm daily

4
Potassium bromide (???)

• Adverse effects
• Therapeutic index is very small.
• GI loss of appetite, N/V
• CNS depression, loss of coordination and
  memory, confusion, headache and
• bromism (somnolence, coma,
  clonic seizures, tremor, ataxia,
  delirium, psychoses etc.)
• Others acne-form dermatitis ,
  mucous hypersecretion in the lungs.

5
Potassium bromide (???)

• Contraindication
• - hypersensitivity to bromide.
• - kidney damage.
• - pregnancy lactation.
• In the body, the drug is in equilibrium with
  NaCl.
• Avoid salt-depletion give salt-supplements
  during hot days, fever with sweating etc.
• The less NaCl in the body , the more toxic
  Potassum bromide is.

6
Chloral hydrate

• ??????????????????? 4 ???????????????????????????
  ?? ??????????????? ?.?.2518
• CNS depressant
• Use sedative-hypnotic (Short-term)
• Dose (Adult)
• hypnotic 500-1000 mg hs
• sedative 250 mg thrice daily.
• (max 2 g/day)
• lethal dose 10 g

7
Chloral hydrate (???)

• Contraindication
• - Severe impairment of renal or hepatic
  function
• - Hypersensitivity to chloral hydrate
• Warnings
• - Abuse and Dependence.
• - Avoid in patients with severe cardiac
  disease,
• gastritis, esophagitis or gastric or
• duodenal ulcer.
• - Caution in Pregnancy and Lactation
• (Pregnancy Risk category C)

8
Chloral hydrate (???)

• Pharmacokinetics
• - rapidly absorped from GI.
• - drowsiness within 10-15 min, sleep within
  30-60 min, which lasts about 4-8 hrs
• - metabolized in the liver by alc
  dehydrogenase to trichloroethanol (major
  active metabolite), widely distributed to
  all body tissues including CSF, breast milk
  and placenta.
• - the half-life of trichlorethanol is 8 hrs.
  - it is oxidized to less active metabolite
  and is excreted in the urine and bile.

9
Chloral hydrate (???)

• Adverse Effects
• GI gastric irritation, N/V
• CNS ataxia, hallucination,
  drowsiness, headache,
  hangover effect
• Dermatological rash, urticaria
• Drug Interaction
• Alcohol or other CNS depressants
• additive CNS
  depressant effect.
• Oral Anticoagulants (Warfarin)
  enhance the
  hypoprothrombinemic response
  to warfarin.

10
Opium Tincture 10

• ?????????????????????????? 2 ???
  ???.?????????????? ?.?.2522
• Opium Tr. (Morphine 10
  mg/ml)
• VS
• Camphorated Opium Tr. (Morphine 0.4 mg/ml)
• Use Treatment of diarrhea or relief of pain
• Dose (Adult)
• Diarrhea 0.3-1 ml every 2-6 hrs to
  maximum of 6 ml/24 hrs
• Analgesia 0.6-1.5 ml/dose every 3-4
  hrs
• Pregnancy Category B/D (prolonged use or high
  doses at term)

11
Opium Tincture 10 (???)

• Warnings
• Abuse and dependence
• Concerned related adverse effects
• CNS depression
• hypotension
• Concerned related disease
• biliary tract impairment
• head injury
• hepatic impairment
• respiratory disease
• Concerned drug therapy issues
  Sedatives

12
Opium Tincture 10 (???)

• Pharmacokinetics
• Absorption variable in GI
• Distribution widely distribute to
  brain,
• cross blood
  brain barrier,
  placenta barrier
• Metabolism hepatic
• Excretion urine
• Half-life 2-3 hr
• Duration 4-5 hrs

13
Opium Tincture 10 (???)

• Adverse effects
• CVS vasodilatation, may lead to
• postural hypotension
• CNS drowsiness, dizziness, sedation,
  miosis
• Respiratory respiratory depression
• GI constipation, stomach cramps,
• biliary tract spasm
• Genitourinary urination decreased,
• urinary tract
  spasm
• Other histamine release

14
Opium Tincture 10 Drug Interaction
15
????????? Opium Mixture

• Rx
• Opium Tincture 10 500 ml
• Potassium bromide 500 gm
• Chloral hydrate 500 gm
• Ethyl alcohol 95 500 ml
• Purified water to 15,000 ml

16
????????? Opium Mixture