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동물 종별 용량

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금기

• Hypersensitivity to narcotic analgesics
• Patients receiving monoamine oxidase inhibitors (MAOIs) like amitraz or selegiline
• Diarrhea caused by toxic ingestion (until toxin is eliminated)
• Repeated use in severe inflammatory bowel disease
• Scorpion stings (Centruroides sculpturatus and C. gertschi) as it may potentiate venom
• Combination products containing acetaminophen are STRICTLY CONTRAINDICATED in cats
• Hypersensitivity to opioids
• Severe respiratory depression or asthma
• Cats (especially if using combination products containing paracetamol)

이상반응

• Sedation (most common)
• Constipation
• Anorexia
• Vomiting
• Ileus
• Biliary and pancreatic duct spasms
• Respiratory depression (at high doses)
• Cats: CNS stimulation, hyperexcitability, tremors, seizures
• Sedation
• Nausea

약물 상호작용

• Anticholinergic drugs · May increase the chances of constipation developing
• Antidepressants (TCAs/MAOIs) · May potentiate CNS depressant effects
• CNS Depressants (anesthetics, antihistamines, phenothiazines, barbiturates, tranquilizers) · May cause increased CNS or respiratory depression
• Quinidine · May inhibit the transformation of codeine to morphine in the liver, decreasing its efficacy
• CNS Depressants (e.g., phenobarbital, diazepam) · Additive CNS and respiratory depression · moderate
• SSRIs / MAOIs · Increased risk of serotonin syndrome · major
• CNS Depressants (e.g., sedatives, anesthetics, antihistamines) · Additive CNS and respiratory depression · major
• Monoamine Oxidase Inhibitors (MAOIs) · May cause severe, unpredictable reactions (serotonin syndrome or severe respiratory depression) · major

모니터링

• Efficacy (pain relief, reduction in coughing, or resolution of diarrhea)
• Adverse effects (sedation, respiratory rate, GI signs)
• Respiratory rate and depth
• Level of sedation
• Pain score or coughing frequency
• Bowel movements (monitor for constipation)

과용량

Opiate overdosage may produce profound **respiratory and/or CNS depression**. Other effects can include cardiovascular collapse, hypothermia, and skeletal muscle hypotonia. * **Decontamination**: Oral ingestions should be removed using standard gut removal protocols. Inducing vomiting should be attempted with caution due to rapid changes in CNS status. * **Antidote**: **Naloxone** is the agent of choice for treating respiratory depression. In massive overdoses, naloxone doses may need to be repeated, as its effects may diminish before subtoxic levels of codeine are attained. * **Supportive Care**: Mechanical respiratory support should be considered in cases of severe respiratory depression. Contact an animal poison control center for further guidance.