Why should codeine often be avoided in patients with COPD?

Why should codeine often be avoided in patients with COPD?

• A. It can accumulate secretions
• B. It increases respiratory drive
• C. It improves mucus clearance
• D. It reduces sedation

Answer: (D)

Opioids like codeine slow breathing and blunt the cough reflex. In COPD, the ability to clear mucus is already challenged, so reduced respiratory drive plus a suppressed cough allows secretions to pool and accumulate. That accumulation increases the risk of hypoventilation, atelectasis, and infection. So the best statement is that it can accumulate secretions. The other ideas don’t fit: codeine does not increase respiratory drive or mucus clearance; it impairs both and it increases, not reduces, sedation, which further jeopardizes ventilation.

Opioids like codeine slow breathing and blunt the cough reflex. In COPD, the ability to clear mucus is already challenged, so reduced respiratory drive plus a suppressed cough allows secretions to pool and accumulate. That accumulation increases the risk of hypoventilation, atelectasis, and infection. So the best statement is that it can accumulate secretions. The other ideas don’t fit: codeine does not increase respiratory drive or mucus clearance; it impairs both and it increases, not reduces, sedation, which further jeopardizes ventilation.