opium tincture, squill oxymel

Action and Spectrum

Actions and Spectrum: 

opium tincture contains various alkaloids derived from the opium poppy, including morphine, codeine, and thebaine. Morphine, in particular, is the primary active component responsible for the analgesic (pain-relieving) effects.

The mechanism of action involves binding to opioid receptors in the central nervous system, primarily the mu-opioid receptors. Activation of these receptors results in inhibition of neurotransmitter release, leading to analgesia, sedation, and other opioid-related effects. 

squill oxymel is a traditional medicinal preparation that combines squill (Urginea maritima) extract with honey and vinegar. squill contains cardioactive compounds, such as cardiac glycosides, which affect the heart. The cardiac glycosides in squill have a positive inotropic effect on the heart muscle, increasing the force of contractions. This action is beneficial in certain cardiovascular conditions. 

Drug Interaction

Adverse Reaction

Frequency not defined 

Sickness  

Drowsiness  

Loss of appetite  

Diarrhoea  

Stomach pain 

Difficulty in urinating  

Rash 

Low blood pressure 

Shortage of breath  

Skin itching and flushing 

Constipation  

Confusion 

Nausea

Black Box Warning

Black box warning: 

None 

Contraindication / Caution

Contraindications/caution: 

Contraindications: 

• Respiratory depression: opium tincture, like other opioids, can cause respiratory depression (slowed breathing). It is contraindicated in individuals with respiratory disorders, especially those with severe chronic obstructive pulmonary disease (COPD) or asthma. 
• Acute or Severe Bronchial Asthma: opioids, including opium tincture, can exacerbate bronchial asthma. Therefore, it is contraindicated in individuals with acute or severe bronchial asthma. 
• Gastrointestinal Obstruction: opium tincture can slow down gastrointestinal motility, and its use is contraindicated in individuals with gastrointestinal Obstruction. 
• Electrolyte Imbalances: Cardiac glycosides, particularly potassium, can affect electrolyte balance. Individuals with significant electrolyte imbalances and deficient potassium levels (hypokalemia) should not use squill oxymel. 
• Hypersensitivity: Individuals with known hypersensitivity or allergy to squill or any component of squill oxymel should not use the preparation. 

Pregnancy / Lactation

Pregnancy consideration: Insufficient data available 

Lactation: Excretion of the drug in human breast milk is unknown 

Pregnancy category: 

Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester. 

Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women. 

Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.    

Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.    

Category X: Drugs listed in this category outweigh the risks over benefits. Hence, these categories of drugs need to be avoided by pregnant women.    

Category N: There is no data available for the drug under this category 

Pharmacology

Pharmacology: 

opium tincture contains alkaloids derived from the opium poppy, including morphine, codeine, and thebaine.squill oxymel combines squill (Urginea maritima) extract with honey and vinegar. 

morphine, the primary active component, acts as an agonist at mu-opioid receptors in the central nervous system. Activation of mu-opioid receptors inhibits neurotransmitter release, leading to analgesia, sedation, and other opioid-related effects. 

squill contains cardioactive compounds, including cardiac glycosides. The cardiac glycosides in squill have a positive inotropic effect on the heart, increasing the force of contractions. squill may also have diuretic properties, leading to increased urine production. 

Pharmacodynamics:  

• Analgesic and Cardiotonic Effects: The combination may theoretically exhibit both analgesic effects from the opium tincture and cardiotonic effects from the squill oxymel. 

The potential interactions between the opioid effects and the cardiovascular effects would need careful consideration, especially in individuals with cardiovascular conditions. 

• Central Nervous System Depression: Both opium tincture and squill oxymel may have central nervous system depressant effects and combining them could potentially increase the risk of sedation, respiratory depression, and other opioid-related side effects. 

Pharmacokinetics: 

Absorption 

opium tincture is typically administered orally. The opium alkaloids, including morphine, are absorbed in the gastrointestinal tract. squill oxymel is commonly administered orally. It is derived from the bulb of the squill plant, and its components are absorbed in the gastrointestinal tract. 

Distribution 

morphine, one of the main alkaloids in opium, is distributed throughout the body, including the central nervous system. The active compounds in squill, such as cardiac glycosides, may be distributed throughout the body. 

Metabolism 

morphine undergoes hepatic metabolism primarily in the liver. It is metabolized to morphine-3-glucuronide and morphine-6-glucuronide, among other metabolites. The metabolism of squill components in the body may occur, but specific details may depend on the compounds present. 

Elimination and Excretion: 

The metabolites of morphine are excreted in the urine. The elimination half-life of morphine can vary, but it is generally relatively short. Excretion pathways for squill oxymel components would likely involve renal excretion through the urine. 

Adminstartion

Administration: 

Oral administration 

It is also administered orally. It can be taken by mouth as directed by a healthcare professional. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: opium tincture, squill oxymel 

Why do we use opium tincture, squill oxymel? 

• Cough Relief: It is often employed to relieve cough associated with respiratory conditions like bronchitis. It may help reduce the frequency and severity of coughing. 
• Respiratory Support: Due to its ability to promote the clearing of respiratory secretions, squill oxymel is used to support the respiratory system in conditions where congestion is a concern.