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Related Concept Videos

Opioid Analgesics: Synthetic and Semisynthetic Opioids01:15

Opioid Analgesics: Synthetic and Semisynthetic Opioids

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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...
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Opioid Receptors: Overview01:22

Opioid Receptors: Overview

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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,...
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Opioid Analgesics: Morphine and Other Natural Cogeners01:20

Opioid Analgesics: Morphine and Other Natural Cogeners

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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...
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Drugs Affecting GI Tract Motility: Opioids as Antidiarrheal Agents01:17

Drugs Affecting GI Tract Motility: Opioids as Antidiarrheal Agents

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Diarrhea, a condition marked by frequent loose or watery bowel movements, can be triggered by multiple factors such as viral or bacterial infections, food intolerances, anxiety, medications, and digestive disorders. Symptoms may include abdominal pain, bloating, nausea, and cramping. Severe or prolonged diarrhea can lead to complications like electrolyte imbalances, malnutrition, and dehydration if left untreated.
Opioids, widely used antidiarrheal agents, mitigate diarrhea by slowing down...
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Toxic Reactions: Overview01:26

Toxic Reactions: Overview

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When toxic substances penetrate the human body, they disseminate to various tissues, undergoing metabolic changes. This process yields reactive metabolites that may covalently bind with specific target molecules, resulting in toxicity.
Toxicity falls into two primary categories: local and systemic.
Local toxicity appears at the exposure site, such as protein denaturation caused by caustic substances.
In contrast, systemic toxicity requires the toxic agent's absorption and distribution,...
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Frequency-dependent Selection01:21

Frequency-dependent Selection

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When the fitness of a trait is influenced by how common it is (i.e., its frequency) relative to different traits within a population, this is referred to as frequency-dependent selection. Frequency-dependent selection may occur between species or within a single species. This type of selection can either be positive—with more common phenotypes having higher fitness—or negative, with rarer phenotypes conferring increased fitness.
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Measuring RAN Peptide Toxicity in C. elegans
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Opioid Toxicity.

David Dolinak1

  • 1Cuyahoga County Medical Examiner's Office.

Academic Forensic Pathology
|June 27, 2019
PubMed
Summary

The rise in opioid overdose deaths is linked to heroin and fentanyl, which severely depress respiration. Autopsies reveal pulmonary edema and congestion as key indicators of opioid toxicity.

Area of Science:

  • Forensic Pathology
  • Toxicology
  • Public Health

Background:

  • Opioid use and fatal overdoses have significantly increased.
  • Transition from prescribed opioids to illicit substances like heroin and fentanyl contributes to this rise.
  • Polysubstance abuse, including with ethanol or benzodiazepines, exacerbates respiratory depression.

Purpose of the Study:

  • To review the key indicators and diagnostic challenges in identifying opioid-related fatalities.
  • To highlight the role of forensic investigation and autopsy findings in drug-related death cases.
  • To emphasize the need for comprehensive toxicology in suspected opioid toxicity cases.

Main Methods:

  • Review of medical and social history.
  • Scene investigation for drug paraphernalia.
Keywords:
FentanylForensic pathologyHeroinOpiateOpioidRespiratory depression

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  • Postmortem examination, including autopsy and toxicology.
  • Consideration of pre-existing medical conditions impacting susceptibility.

    • Main Results:

    • Pulmonary edema and congestion with frothy airway fluid are significant autopsy findings.
    • Physical evidence like needle tracks may suggest drug use.
    • Routine toxicology may miss novel or synthetic opioids, necessitating specialized testing.

    Conclusions:

    • Opioid toxicity poses a critical public health threat, often leading to fatal respiratory depression.
    • A thorough investigative approach combining scene, history, autopsy, and advanced toxicology is crucial for accurate determination of drug-related deaths.
    • Underlying health conditions can increase vulnerability to opioid-induced respiratory compromise.