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Related Concept Videos

Opioid Analgesics: Synthetic and Semisynthetic Opioids01:15

Opioid Analgesics: Synthetic and Semisynthetic Opioids

Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
Opioid Analgesics: Morphine and Other Natural Cogeners01:20

Opioid Analgesics: Morphine and Other Natural Cogeners

Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
Analgesia and Pain Management01:25

Analgesia and Pain Management

Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
Drug Dependence01:17

Drug Dependence

Medications are typically administered to achieve therapeutic effects. Some drugs can modify an individual's mood and perception, frequently resulting in various enjoyable experiences. However, this can result in drug dependency, a condition marked by continuous drug use despite potential negative consequences. Drug dependency primarily falls into two categories: psychological and physical dependence. Psychological dependence occurs when the pleasurable feelings induced by the drug...
Drug Abuse and Addiction: Pharmacological Phenomena01:15

Drug Abuse and Addiction: Pharmacological Phenomena

Drug dependence, abuse, and addiction are complex phenomena that can precipitate various abnormal states. Physical dependence refers to a state of pharmacological adaptation to a drug. This adaptation often results in tolerance—a reduced response to the drug after repeated administrations. When the drug use is abruptly stopped, withdrawal symptoms occur due to the body's need to readjust from the pharmacologically induced imbalance. However, tolerance and withdrawal symptoms do not necessarily...
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Opioid Receptors: Overview

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Opioid dependence and pregnancy.

Bernadette Winklbaur1, Erika Jung, Gabriele Fischer

  • 1Department of Psychiatry & Psychotherapy, Medical University of Vienna, Austria.

Current Opinion in Psychiatry
|April 3, 2008
PubMed
Summary

Opioid dependence in pregnancy requires standardized care, with opioid maintenance therapy recommended. Neonatal Abstinence Syndrome (NAS) management needs attention, as current approaches lack evidence-based designs, leading to prolonged hospital stays.

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Area of Science:

  • Obstetrics and Gynecology
  • Neonatal Medicine
  • Addiction Medicine

Background:

  • Opioid dependence during pregnancy is a significant concern.
  • Management strategies have evolved over the past 30 years.
  • Neonatal Abstinence Syndrome (NAS) is a common consequence of intrauterine opioid exposure.

Purpose of the Study:

  • To review and discuss recent literature on opioid dependence in pregnancy.
  • To evaluate current management practices for pregnant women with opioid dependence.
  • To assess treatment approaches for Neonatal Abstinence Syndrome.

Main Methods:

  • Systematic review of peer-reviewed literature.
  • Evaluation of studies in pregnancy, opioid dependence, and NAS.
  • Discussion of existing management and treatment protocols.

Main Results:

  • Standardized maternal care is crucial for minimizing fetal harm.
  • Opioid maintenance therapy is the recommended treatment during pregnancy.
  • NAS affects 55-94% of exposed neonates, with 60% requiring treatment.
  • Heterogeneous rating scales and treatments contribute to extended hospital stays for NAS.

Conclusions:

  • Methodological flaws complicate the interpretation of current literature.
  • There is a lack of evidence-based study designs for treating maternal opioid dependence during pregnancy.
  • Evidence-based guidelines are needed for the pharmacological treatment of NAS.