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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...
Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
Local Anesthetics: Common Agents and Their Applications01:23

Local Anesthetics: Common Agents and Their Applications

Local anesthetics (LAs) are commonly used for various applications in medical and dental procedures. Some of the common agents used are cocaine, lidocaine, and bupivacaine.
Cocaine is an ester of benzoic acid and methylecgogine. It is used to anesthetize and vasoconstrict locally. Currently, it is used primarily for topical applications. It is beneficial for surgeries on the upper respiratory tract, providing anesthesia and shrinking the mucosa. Cocaine in the form of cocaine hydrochloride is...
Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
General Anesthesia: Overview01:24

General Anesthesia: Overview

Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...

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Related Experiment Video

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Facial Nerve Surgery in the Rat Model to Study Axonal Inhibition and Regeneration
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Anesthesia for patients on buprenorphine.

Ethan O Bryson1, Scott Lipson, Clifford Gevirtz

  • 1Department of Anesthesia, Mount Sinai Medical Center, 1 Gustave Levy Plaza, New York, NY 10029, USA.

Anesthesiology Clinics
|November 16, 2010
PubMed
Summary

Opioid abuse treatment is complicated by access and legal barriers. The Drug Addiction Treatment Act of 2000 (DATA 2000) now allows physicians to prescribe buprenorphine for opioid addiction treatment.

Area of Science:

  • Addiction Medicine
  • Pharmacology
  • Public Health Policy

Background:

  • Opioid abuse presents a significant and escalating public health crisis in the United States.
  • Treatment for opioid dependence faces substantial obstacles, including limited access to care and legal restrictions.
  • Current treatment options, such as methadone maintenance programs, reach only a small fraction (12%-15%) of the affected population.

Purpose of the Study:

  • To highlight the impact of the Drug Addiction Treatment Act of 2000 (DATA 2000) on opioid addiction treatment.
  • To introduce buprenorphine as a legally prescribable medication for opioid addiction.
  • To discuss the implications of DATA 2000 for expanding treatment accessibility.

Main Methods:

  • Review of legislative changes impacting opioid addiction treatment.

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  • Analysis of the introduction of buprenorphine as a treatment option.
  • Discussion of the historical context of physician-prescribed opioid addiction therapies.

    • Main Results:

    • The passage of DATA 2000 marked a significant policy shift, enabling physicians to prescribe medications for opioid addiction.
    • Buprenorphine was approved as the first opioid medication for office-based treatment of opioid addiction.
    • This legislation aimed to overcome previous barriers to medication-assisted treatment.

    Conclusions:

    • DATA 2000 represents a landmark achievement in addiction medicine, broadening treatment options.
    • Buprenorphine offers a new avenue for patients seeking medication-assisted treatment for opioid use disorder.
    • The act has the potential to increase access to evidence-based care for opioid dependence.