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Hydrocodone

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Description

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What is hydrocodone ?

Hydrocodone is an antitussive (cough suppressant) and narcotic analgesic agent for the treatment of moderate to moderately severe pain. Studies indicate that hydrocodone is as effective, or more effective, than codeine for cough suppression and nearly equipotent to morphine for pain relief. Hydrocodone is the most frequently prescribed opioid in the United States with more than 136.7 million prescriptions for hydrocodone-containing products dispensed in 2013 along with 93.7 million dispensed in 2016 and 83.6 million sold to patients in 2017.

Mechanism of action

Hydrocodone binds to the mu opioid receptor (MOR) with the highest affinity followed by the delta opioid receptors (DOR). Hydrocodone’s agonist effect at the MOR is considered to contribute the most to its analgesic effects. Both MOR and DOR are Gi/o coupled and and produces its signal through activation of inward rectifier potassium (GIRK) channels, inhibition of voltage gated calcium channel opening, and decreased adenylyl cyclase activity. In the dorsal horn of the spinal cord, activation of pre-synaptic MOR on primary afferents the inhibition of calcium channel  opening and increased activity of GIRK channels hyperpolarizes the neuron and prevents release of neuurotransmitters. Post-synaptic MOR can also prevent activation of neurons by glutamate through the aforementioned mechanisms.

Indication of hydrocodone

Hydrocodone is indicated for the management of acute pain, sometimes in combination with acetaminophen or ibuprofen, as well as the symptomatic treatment of the common cold and allergic rhinitis in combination with decongestants, antihistamines, and expectorants.

Adverse Effects

As with most opiates, abuse of hydrocodone is associated with tolerance, dependence, and addiction. The co-formulation with acetaminophen carries an additional risk of liver toxicity when high, acute doses are consumed

User Population of hydrocodone

Every age group has been affected by the relative ease of hydrocodone availability and the perceived safety of these products by medical prescribers. Sometimes viewed as a “white collar” addiction, hydrocodone abuse has increased among all ethnic and economic groups.

Illicit Distribution

Hydrocodone has been encountered in tablets, capsules, and liquid form in the illicit market. However, hydrocodone tablets with the co-ingredient, acetaminophen, is the most frequently encountered form. Hydrocodone is not typically found to be clandestinely produced; diverted pharmaceuticals are the primary source of the drug for abuse purposes. Doctor shopping, altered or fraudulent prescriptions, bogus call-in prescriptions, diversion by some physicians and pharmacists, and drug theft are also major sources of the diverted drug.
The National Forensic Laboratory

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30 tablets, 60 tablets, 90 tablets, 120 tablets

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