Which one is a narcotic drug?

Appeared in: AIIMS Nagpur NO - 2018

Explanation

Codeine is an opioid analgesic, which falls under the category of narcotic drugs.
It is derived from the opium poppy and has a lower binding affinity to μ-opioid receptors compared to morphine.
Its primary uses are for the management of mild to moderate pain and as an antitussive (cough suppressant).
Due to its potential for abuse and dependence, it is a controlled substance.

Option A: Paracetamol is a non-opioid analgesic and antipyretic. It relieves pain and reduces fever but does not have the properties of a narcotic and is not a controlled substance.
Option B: Pantoprazole is a proton pump inhibitor (PPI). Its function is to reduce the production of stomach acid and it is used to treat conditions like GERD and peptic ulcers. It has no analgesic or narcotic properties.
Option D: Emset is a brand name for Ondansetron. It is a 5-HT3 receptor antagonist, which is a class of antiemetic drugs. Its sole purpose is to prevent nausea and vomiting, often associated with chemotherapy, radiation, or surgery. It is not a narcotic.

Visual 1: Infographic: The WHO Analgesic Ladder, showing the three steps of pain management, placing weak opioids like codeine on the second step.
Visual 2: Chart: Comparing the mechanisms of action and side effect profiles of opioid (narcotic) and non-opioid analgesics.

Clinical Relevance

Nursing practice connection: Knowing Pharmacology: Classification of Narcotic Drugs helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Nurses must adhere to strict legal and facility protocols for handling narcotics, including witness requirements for wasting unused portions of a dose.
Patient education is crucial. Nurses should teach patients about the potential for drowsiness and advise against driving or operating heavy machinery.
A key nursing assessment before administering codeine is checking the patient's respiratory rate. If the rate is below 12 breaths per minute, the dose should be withheld and the provider notified.

How to Approach the Question

First, understand the question. It asks to identify a 'narcotic drug' from the given options.
Recall the definition of a narcotic drug: a substance that relieves pain and induces drowsiness, stupor, or insensibility; typically an opioid.
Systematically evaluate each option based on its pharmacological classification.
Paracetamol: Recall it's a common analgesic/antipyretic, but not an opioid.
Pantoprazole: Recall it's a PPI for stomach acid, unrelated to pain or narcotics.
Codeine: Recall this is a well-known opioid, used for pain and cough, fitting the definition of a narcotic.

Concept Tested & Keywords

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KD Tripathi - Essentials of Medical Pharmacology (6th Edition) p. 45-47

Practise the full AIIMS Nagpur NO - 2018

Attempt every question from this paper in a timed mock, then review the full solution for each one.