PAREGORIC (CAMPHORATED OPIUM TINCTURE)
| PAREGORIC (CAMPHORATED OPIUM TINCTURE) (par-e-gor'ik) Classifications: antidiarrheal; narcotic (opiate) agonist analgesic; Therapeutic: antidiarrheal; opiate Prototype: Loperamide Pregnancy Category: C Controlled Substance: Schedule III |
Availability
2 mg/5 mL liquid
Action
Contains 2 mg anhydrous morphine, alcohol, benzoic acid, camphor, and anise oil. Pharmacologic activity is due to morphine content. Increases smooth muscle tone of GI tract, decreases motility and effective propulsive peristalsis while diminishing digestive secretions.
Therapeutic Effect
Delayed transit of intestinal contents results in desiccation of feces and constipation.
Uses
Short-term treatment for symptomatic relief of acute diarrhea and abdominal cramps.
Contraindications
Hypersensitivity to opium alkaloids; diarrhea caused by poisons (until eliminated); COPD; pregnancy (category C).
Cautious Use
Asthma; liver disease; GI disease; history of opiate agonist dependence; severe prostatic hypertrophy, lactation.
Route & Dosage
| Acute Diarrhea Adult: PO 5–10 mL after loose bowel movement, 1–4 times daily if needed Child: PO 0.25–0.5 mL/kg 1–4 times/d |
Administration
Oral- Give paregoric in sufficient water (2 or 3 swallows) to ensure its passage into the stomach (mixture will appear milky).
Adverse Effects (≥1%)
GI: Anorexia, nausea, vomiting, constipation, abdominal pain. Body as a Whole: Dizziness, faintness, drowsiness, facial flushing, sweating, physical dependence.Interactions
Drug: Alcohol and other cns depressants add to CNS effects.Pharmacokinetics
Absorption: Readily from GI tract. Duration: 4–5 h. Distribution: Crosses placenta; distributed into breast milk. Metabolism: In liver. Elimination: In urine. Half-Life: 2–3 h.Nursing Implications
Assessment & Drug Effects
- Paregoric may worsen the course of infection-associated diarrhea by delaying the elimination of pathogens.
- Be aware that adverse effects are primarily due to morphine content. Paregoric abuse results because of the narcotic content of the drug.
- Assess for fluid and electrolyte imbalance until diarrhea has stopped.
Patient & Family Education
- Adhere strictly to prescribed dosage schedule.
- Maintain bed rest if diarrhea is severe with a high level of fluid loss.
- Replace fluids and electrolytes as needed for diarrhea. Drink warm clear liquids and avoid dairy products, concentrated sweets, and cold drinks until diarrhea stops.
- Observe character and frequency of stools. Discontinue drug as soon as diarrhea is controlled. Report promptly to physician if diarrhea persists more than 3 d, if fever is >38.8° C (102° F), abdominal pain develops, or if mucus or blood is passed.
- Understand that constipation is often a consequence of antidiarrheal treatment and a normal elimination pattern is usually established as dietary intake increases.
Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; 
Canadian drug name; 
Prototype drug