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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...
Opioid Receptors: Overview01:22

Opioid Receptors: Overview

Opioid receptors, including the mu (μ, MOR), delta (δ, DOR), and kappa (κ, KOR) types, belong to the rhodopsin family of G protein-coupled receptors. These receptors are located throughout the central and peripheral nervous systems and in non-neuronal tissues such as macrophages and astrocytes. Opioid receptor ligands can be categorized into agonists or antagonists. Highly selective agonists include [d-Ala2, MePhe4, Gly(ol)5]-enkephalin or DAMGO for MOR, [D-Pen2, D-Pen5]-enkephalin or DPDPE for...
Therapeutic Drug Monitoring: Drug Analysis Methods01:26

Therapeutic Drug Monitoring: Drug Analysis Methods

Therapeutic Drug Monitoring (TDM) is a clinical practice that measures specific drug levels in a patient's blood or body tissues to tailor drug therapy effectively. This monitoring is critical for managing drugs with narrow therapeutic indices like digoxin and phenytoin, ensuring they are both safe and effective. For instance, monitoring theophylline levels in asthma patients involves precision and sensitivity to adjust doses according to individual responses to therapy, ensuring efficacy and...
Drug Concentrations: Measurements01:23

Drug Concentrations: Measurements

Drug concentration is the quantity of a drug present in a biological sample. Measuring drug amounts in biological samples allows the clinician to understand how a drug is absorbed, distributed, metabolized, and excreted. Samples can be obtained through invasive or non-invasive methods. Invasive techniques involve surgical or parenteral interventions to gather blood, cerebrospinal fluid, or tissue biopsy. Conversely, non-invasive approaches provide samples like urine, feces, and saliva.
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High-throughput and Comprehensive Drug Surveillance Using Multisegment Injection-Capillary Electrophoresis-Mass Spectrometry
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Laboratory testing for prescription opioids.

Michael C Milone1

  • 1Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA. milone@mail.med.upenn.edu

Journal of Medical Toxicology : Official Journal of the American College of Medical Toxicology
|November 27, 2012
PubMed
Summary
This summary is machine-generated.

Laboratory testing is crucial for detecting prescription opioid misuse and intoxication. Understanding opioid metabolism and test sensitivity is essential for accurate interpretation in clinical settings.

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Area of Science:

  • Forensic Toxicology
  • Clinical Chemistry
  • Pharmacology

Background:

  • Opioid analgesic misuse has surged, becoming a leading cause of poisoning deaths in the USA.
  • Prescription opioid abuse is a significant public health concern, necessitating reliable detection methods.
  • Laboratory testing is vital for identifying opioid misuse and managing intoxication.

Purpose of the Study:

  • To review the role and challenges of laboratory testing in the context of the opioid epidemic.
  • To highlight the importance of understanding opioid metabolism and assay sensitivity for accurate drug testing.
  • To emphasize the need for improved testing algorithms and clinical research in pain medicine and substance abuse.

Main Methods:

  • Utilizes immunoassay and chromatographic methods (e.g., LC-MS) for sensitive and specific opioid detection.
  • Discusses the evolution of testing from workplace drug screening to clinical monitoring of prescription opioids.
  • Explores the analysis of various biological samples including urine, saliva, sweat, and hair.

Main Results:

  • Current testing methods are essential for detecting a wide range of opioids, addressing the prescription opioid epidemic.
  • Drug metabolism can alter opioid compounds, complicating interpretation of test results.
  • Varying sensitivity of different assays across opioid drugs necessitates careful selection and interpretation.

Conclusions:

  • Effective use of opioid drug testing requires a thorough understanding of drug metabolism and method sensitivity.
  • Further research and improved testing algorithms are needed for optimal application in clinical settings, especially in pain management and addiction treatment.
  • Laboratory analysis plays a critical role in addressing the opioid crisis through detection and monitoring.