Opiate Information
In medicine, the term opiate describes any of the narcotic opioid alkaloids found as natural products in the opium poppy plant, Papaver somniferum.[1]
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Overview
Opiates are so named because they are constituents or derivatives of constituents found in opium, which is processed from the latex sap of the opium poppy. The major biologically active opiates found in opium are morphine, codeine, and thebaine. Semi-synthetic opiates such as hydrocodone, hydromorphone, and oxymorphone are derived from these substances. Papaverine, noscapine and approximately 24 other alkaloids are also present in opium, but have little to no effect on the human central nervous system, and are not considered to be opiates.
Opiates belong to the large biosynthetic group of benzylisoquinoline alkaloids.
The full synthesis of opiates from naphthoquinone (Gates synthesis) or from other simple organic starting materials is tedious and not economical. Thus, most of the opiate-type analgesics in use today are extracted from Papaver somniferum or semi-synthesized from thebaine.[2]
Terminology
In the traditional sense, opiate has referred to only the alkaloids in opium and the natural and semi-synthetic derivatives of opium. The term is often incorrectly used to refer to all drugs with opium- or morphine-like pharmacological action, which are more properly classified under the broader terms opioid.
The alkaloids
Morphine
Main article: Morphine Chemical structure of morphineThe most frequently-reported occurrences of opiate-induced pulmonary edema are among recreational heroin users.[3][4] Although uncommon, reports of morphine-induced pulmonary edema are not unheard of.[5] The primary difference is the more careful supervision of morphine administration compared to the lack of supervision and medical expertise among illicit heroin users. On the other hand, morphine may also be used in the treatment of pulmonary edema.[6][7] Despite morphine's being the most medically-significant alkaloid, larger quantities of the milder codeine—most of it manufactured from morphine—are consumed medically, as codeine has a greater and more predictable oral bioavailability than morphine, making it easier to titrate one's dose.
Morphine addiction cure advertisement in the year 1900As heroin is not pharmacologically active it must first be metabolized. The active metabolites of heroin are morphine, 6-monoacetylmorphine and 3-monoacetylmorphine.
Codeine
Main article: Codeine CodeineEsters of Morphine
Semi-natural opiates that are either morphine prodrugs or are so similar to morphine that they are not semi-synthetic, but are more natural in nature due to the fact that they are morphine salts. Examples of such drugs include diacetylmorphine (morphine diacetate; heroin) (morphine prodrug), the metabolite 6-MAM (morphine prodrug), nicomorphine (morphine dinicotinate), dipropanoylmorphine (morphine dipropionate), desomorphine (di-hydro-desoxy-morphine), methyldesorphine, acetylpropionylmorphine, dibenzoylmorphine, diacetyldihydromorphine, and several others.[8]
Withdrawal effects
Opiate withdrawal syndrome effects are associated with cessation of prolonged opiate usage.
In facilities the logical threat of relapse is possible when Post-acute-withdrawal syndrome is under-emphasized to patients in transitional phases, especially with short-term suboxone, methadone or health facilities.
See also
References
- ^ "Opiate - Definitions from Dictionary.com". dictionary.reference.com. http://dictionary.reference.com/browse/Opiate. Retrieved 2008-07-04.
- ^ Synthesis of morphine alkaloids Presentation School of Chemical Sciences, University of Illinois at Urbana-Champaign retrieved 12-02-2010
- ^ Sporer KA, Dorn E (Nov 2001). "Heroin-related noncardiogenic pulmonary edema : a case series". Chest 120 (5): 1628–32. doi:10.1378/chest.120.5.1628. PMID 11713145. http://www.chestjournal.org/cgi/pmidlookup?view=long&pmid=11713145.
- ^ Steensen P, Jørgensen HS, Juhl B (Sep 1993). "[Heroin-induced pulmonary edema]" (in Danish). Ugeskr. Laeg. 155 (37): 2866–8. PMID 8259608.
- ^ Wang WS, Chiou TJ, Hsieh RK, Liu JH, Yen CC, Chen PM (Oct 1997). "Lethal acute pulmonary edema following intravenous naloxone in a patient received unrelated bone marrow transplantation". Zhonghua Yi Xue Za Zhi (Taipei) 60 (4): 219–23. PMID 9439052. http://www.vghtpe.gov.tw/~cmj/6004/600408.htm.
- ^ Pino F, Puerta H, D'Apollo R, et al. (Feb 1993). "Effectiveness of morphine in non-cardiogenic pulmonary edema due to chlorine gas inhalation". Vet Hum Toxicol 35 (1): 36. PMID 8434449.
- ^ Mattu A, Martinez JP, Kelly BS (Nov 2005). "Modern management of cardiogenic pulmonary edema". Emerg. Med. Clin. North Am. 23 (4): 1105–25. doi:10.1016/j.emc.2005.07.005. PMID 16199340.
- ^ "Esters of Morphine". United Nations Office on Drugs and Crime. http://www.unodc.org. http://www.unodc.org/unodc/en/data-and-analysis/bulletin/bulletin_1953-01-01_2_page009.html. Retrieved 10 March 2012.
External links
- World Health Organization guidelines for the availability and accessibility of controlled substances
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Adjective
opiate (not comparable)- Relating to, resembling, or containing opium.
- Soporific; inducing sleep or sedation.
- Deadening; causing apathy or dullness.
- A drug, hormone or other substance derived from or related to opium.
- Something that dulls the senses and induces a false and unrealistic sense of contentment.