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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...
251
Opioid Analgesics: Morphine and Other Natural Cogeners01:20

Opioid Analgesics: Morphine and Other Natural Cogeners

192
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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Analgesia and Pain Management01:25

Analgesia and Pain Management

552
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...
552
Opioid Receptors: Overview01:22

Opioid Receptors: Overview

588
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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Drugs Affecting GI Tract Motility: Opioids as Antidiarrheal Agents01:17

Drugs Affecting GI Tract Motility: Opioids as Antidiarrheal Agents

178
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...
178
Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

111
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.
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Related Experiment Video

Updated: Jun 13, 2025

An Experimental Paradigm for the Prediction of Post-Operative Pain PPOP
14:56

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Mitigating and preventing perioperative opioid-related harm.

Monica W Harbell1, Jonathan Cohen2, Greg Balfanz3

  • 1Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Phoenix, Arizona.

Current Opinion in Anaesthesiology
|September 9, 2024
PubMed
Summary

Perioperative opioid use for acute pain can lead to significant harm, including addiction and respiratory depression. Strategies like nonopioid analgesia and opioid stewardship are crucial to mitigate these risks during the perioperative period.

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Area of Science:

  • Anesthesiology
  • Pain Management
  • Pharmacology

Background:

  • Opioids are essential for managing acute surgical pain but carry substantial risks.
  • Perioperative opioid exposure can initiate long-term use and lead to adverse events.
  • Risks include mild side effects to life-threatening respiratory depression and death.

Purpose of the Study:

  • To review opioid-related harm in the perioperative period.
  • To discuss strategies for mitigating opioid-related harm.
  • To examine policy and guidelines for perioperative opioid management.

Main Methods:

  • Literature review of perioperative opioid management strategies.
  • Discussion of interventions to reduce opioid-related harm.
  • Analysis of current policies and guidelines.

Main Results:

  • Opioid-naive patients are vulnerable to opioid exposure and harm during surgery.
  • Overprescribing contributes to diversion and drug-driving.
  • Mitigation strategies include optimizing nonopioid analgesia and Enhanced Recovery after Surgery (ERAS) programs.

Conclusions:

  • Effective respiratory monitoring, patient education, and opioid stewardship are vital.
  • Addressing challenges and future directions is necessary to minimize perioperative opioid harm.
  • Policy and guideline review is essential for improved perioperative opioid management.