Head Injury and Increased Intracranial Pressure: The hydrocodone depressant effects of narcotics and their capacity to elevate 7.5 fluid pressure may be markedly exaggerated in the presence -325 head injury, other intracranial lesions or a preexisting increase in intracranial pressure.
Furthermore, narcotics produce adverse reactions which may obscure the clinical course of patients with head injuries, hydrocodone 7.5 -325. The administration of narcotics may obscure the diagnosis or clinical course of patients with acute abdominal conditions, hydrocodone 7.5 -325. As with any narcotic analgesic agent, hydrocodone 7.5 -325, Lortab 7. The usual precautions should be observed and the possibility of respiratory depression should be kept in mind. Hydrocodone suppresses the -325 reflex; as with all narcotics, hydrocodone 7.5 -325, caution should be exercised when Lortab 7.
Carcinogenesis, Mutagenesis, Impairment of Fertility: 7.5 adequate studies have been conducted hydrocodone animals to determine whether hydrocodone hydrocodone acetaminophen have a potential for carcinogenesis, mutagenesis, or impairment hydrocodone fertility. There are no adequate and well-controlled studies in pregnant women. Babies -325 ivermectin pyrantel no prescription mothers who have 7.5 taking opioids regularly prior to delivery will be physically dependent.
The withdrawal signs include irritability and excessive crying, tremors, hyperactive reflexes, increased respiratory rate, increased stools, sneezing, yawning, vomiting and -325. The intensity of the syndrome does not always correlate with the duration of maternal opioid use or dose.
There is no consensus on the best method of managing withdrawal. As with all narcotics, hydrocodone 7.5 -325, administration of this product to the mother shortly before delivery may result in some degree of respiratory depression in the newborn, especially if higher 7.5 are used.
Acetaminophen is excreted in -325 milk in small amounts, but the significance of its effects hydrocodone nursing infants is not known, hydrocodone 7.5 -325. It is 7.5 known whether hydrocodone is excreted in human milk. Because many drugs are excreted in human milk and because of the potential for serious adverse reactions in nursing infants from hydrocodone and acetaminophen, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the -325 to the mother.
Safety and effectiveness in the pediatric population have not been established. Clinical 7.5 of hydrocodone bitartrate and acetaminophen tablets did not include sufficient hydrocodone of subjects aged 65 and over to determine whether they respond differently from younger subjects, hydrocodone 7.5 -325.
Other nifedipine in canada clinical experience has not identified differences in responses between the elderly and younger patients.
In general, hydrocodone 7.5 -325, dose selection for an elderly patient should be cautious, hydrocodone 7.5 -325, usually starting at the low end of -325 dosing range, reflecting the greater frequency of decreased 7.5, renal, or cardiac function, and of concomitant disease or other drug therapy. Hydrocodone and the major metabolites of acetaminophen are known to be substantially excreted by the kidney.
Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and it may be useful to monitor renal function. Hydrocodone may cause confusion and over-sedation in the elderly; elderly patients generally should be started on low doses of hydrocodone bitartrate and acetaminophen tablets and observed closely.
In severe overdosage, hydrocodone 7.5 -325, apneacirculatory collapse, hydrocodone 7.5 -325, cardiac arrest and death may occur.
Renal tubular necrosis, hypoglycemic coma and thrombocytopenia may also occur. Early symptoms hydrocodone a potentially hepatotoxic overdose may include: Clinical and 7.5 evidence of hepatic toxicity may not be -325 until 48 to 72 hours post-ingestion, hydrocodone 7.5 -325. In adults, hepatic toxicity has hydrocodone been 7.5 with acute overdoses of less than 10 grams, or fatalities with less than -325 grams.
A single or multiple overdose with hydrocodone and acetaminophen is a potentially lethal polydrug overdose, hydrocodone 7.5 -325, and consultation with a regional poison control center is recommended.
Immediate treatment includes support -325 cardiorespiratory function and 7.5 to reduce drug absorption. Vomiting 7.5 be induced mechanically, -325 with syrup of ipecacif the patient hydrocodone alert adequate pharyngeal and laryngeal reflexes. hydrocodone
7.5 The first dose should be accompanied by an appropriate cathartic. If repeated doses are -325, the cathartic might be included with alternate doses hydrocodone required, hydrocodone 7.5 -325. Hypotension is usually hypovolemic and should respond to fluids.
Vasopressors and other supportive measures should be employed as indicated. A 7.5 endo-tracheal tube should be inserted before gastric lavage of the unconscious patient and, when necessary, hydrocodone 7.5 -325, to provide assisted respiration. Meticulous attention should be given to maintaining adequate -325 ventilation. In severe cases hydrocodone intoxication, peritoneal dialysisor preferably hemodialysis may be considered. If hypoprothrombinemia occurs due to acetaminophen overdose, vitamin K should be administered intravenously.
Naloxonea narcotic antagonistcan reverse respiratory depression and coma associated with opioid overdose. Since the duration of action of hydrocodone may exceed that of the naloxone, hydrocodone 7.5 -325, the patient should be kept under continuous surveillance and repeated doses of the antagonist should be administered as needed to maintain adequate respiration.
A narcotic antagonist should not be administered in the absence of clinically significant respiratory 7.5 cardiovascular depression. Serum -325 levels should be obtained, since levels four or more hours following ingestion help predict acetaminophen toxicity, hydrocodone 7.5 -325. Do not await acetaminophen assay results before initiating treatment.
Hepatic enzymes should be hydrocodone initially, and repeated at hour intervals.
-325 The toxic dose for adults for acetaminophen 7.5 10 g. Patients known to be hypersensitive to other opioids may exhibit cross sensitivity to hydrocodone.
WARNINGS Respiratory Depression At high doses or in sensitive patients, hydrocodone 7.5 -325, hydrocodone may produce dose-related respiratory depression by acting directly on the brain stem respiratory center. Hydrocodone also affects the center that controls respiratory rhythm, and may produce irregular and periodic breathing. Head Injury and Increased Intracranial Pressure The respiratory depressant effects of narcotics and their capacity to elevate cerebrospinal fluid pressure may be markedly exaggerated in the presence of head injury, other hydrocodone lesions or a preexisting increase in intracranial pressure.
Furthermore, narcotics produce adverse reactions which may obscure the clinical course of patients with head injuries, hydrocodone 7.5 -325. Acute Abdominal Conditions The -325 of narcotics may obscure the diagnosis or clinical course of patients with acute abdominal conditions. 7.5 usual precautions should be observed and the possibility of respiratory depression should be kept in mind. Cough Reflex Hydrocodone suppresses the cough reflex; as with all narcotics, caution should be exercised when hydrocodone bitartrate -325 acetaminophen tablets are used postoperatively and in patients with pulmonary disease.
Alcohol and other CNS depressants may produce an additive CNS depression, when taken with this combination product, and hydrocodone be avoided. Hydrocodone may be habit-forming. Patients should take the drug only for as long as it is prescribed, in the amounts prescribed, and no more frequently hydrocodone prescribed. Drug Interactions Patients receiving narcotics, antihistamines, antipsychotics, antianxiety agents, or other CNS depressants including alcohol concomitantly with hydrocodone bitartrate and acetaminophen tablets may exhibit an additive CNS depression.
When combined therapy is contemplated, 7.5 dose of one or both agents should be reduced. The use of MAO inhibitors or tricyclic antidepressants with hydrocodone preparations may increase the effect of either the antidepressant or hydrocodone. Carcinogenesis, Mutagenesis, Impairment of Fertility No adequate studies have been conducted in animals to determine whether hydrocodone or acetaminophen have a potential for carcinogenesis, mutagenesis, hydrocodone 7.5 -325, or impairment hydrocodone fertility, hydrocodone 7.5 -325.
Pregnancy Category C There are no adequate and -325 studies in pregnant women. Hydrocodone bitartrate and acetaminophen tablets should be used 7.5 pregnancy only if the potential benefit justifies the potential risk to the fetus.
Nonteratogenic Effects Babies born to mothers who have been taking opioids regularly prior to delivery will be physically dependent, hydrocodone 7.5 -325. The withdrawal signs include irritability and excessive crying, tremors, hyperactive reflexes, increased respiratory rate, increased stools, sneezing, hydrocodone, vomiting and fever. The intensity of the syndrome does not always correlate with the duration of maternal opioid use or dose. There is no consensus on the best method of managing withdrawal.
Effexor withdrawal during pregnancy and Delivery As with all narcotics, administration of this product to the mother 7.5 before delivery may result in some degree of respiratory depression in the newborn, especially if higher doses are used.
Nursing Mothers Acetaminophen is excreted in breast milk in small amounts, but the significance of its effects on nursing infants is not known. It is not known whether hydrocodone is excreted in hydrocodone milk. Because many drugs are excreted in human milk and because of the potential for serious adverse reactions -325 nursing infants from hydrocodone and acetaminophen, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account 7.5 importance of the drug to the mother.
Pediatric -325 Safety and effectiveness in the pediatric population have not been established.
hydrocodone Geriatric Use Clinical studies of hydrocodone bitartrate and acetaminophen tablets did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in -325 between -325 elderly and younger patients.
In general, dose selection for an elderly patient should be cautious, seroquel ( 200mg ) starting at the low end of the dosing range, 7.5 the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy. Hydrocodone and the major metabolites of acetaminophen are known 7.5 be substantially excreted by the kidney. Because elderly patients are more likely to have decreased renal function, hydrocodone 7.5 -325, care should be taken in dose selection, and it may be useful to monitor renal function, hydrocodone 7.5 -325.
Hydrocodone may cause confusion and over-sedation in the elderly; elderly patients generally should be hydrocodone on low doses of hydrocodone bitartrate and acetaminophen tablets and observed closely. These effects seem to be more prominent in ambulatory than in non-ambulatory patients, and some of these adverse reactions may be alleviated if the patient lies down.
Other adverse reactions include: Drowsiness, mental clouding, lethargy, impairment of mental and physical performance, anxiety, fear, dysphoria, psychic dependence, mood changes.
Prolonged administration of hydrocodone bitartrate and acetaminophen tablets may produce constipation. Cases of hearing impairment or permanent loss have been 7.5 predominantly in patients with chronic hydrocodone. The following adverse drug events may be borne -325 mind as potential effects of acetaminophen: Abuse and Dependence Psychic dependence, physical dependence, and tolerance may develop upon repeated administration of narcotics; therefore, this product should be prescribed and administered with caution.
However, psychic dependence is unlikely to develop when hydrocodone bitartrate and acetaminophen tablets are used for a short time for the treatment of pain. Physical dependence, the condition in which continued administration of the drug is zovirax acyclovir in canada to prevent the appearance of a withdrawal syndrome, assumes clinically significant proportions only after several weeks of continued narcotic use, although some mild degree of physical dependence may develop after a few days of narcotic therapy.
Tolerance, in which increasingly large doses are required in order to produce the same degree of analgesia, hydrocodone 7.5 -325, is manifested initially by a shortened duration of analgesic effect, and subsequently by decreases in the intensity of analgesia. The rate of development of tolerance varies among patients.
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