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Related Concept Videos

Obesity01:24

Obesity

296
The Body Mass Index (BMI) is a numerical value derived from a person's weight and height, used to categorize individuals into weight ranges. It is calculated using the formula: weight in kilograms divided by height in meters squared. Obesity is a health condition characterized by excessive accumulation of adipose tissue that poses health risks, often diagnosed with a BMI ≥ 30. This excess fat storage occurs when surplus dietary calories are converted into triglycerides and stored in...
296
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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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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Analgesia and Pain Management01:25

Analgesia and Pain Management

392
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...
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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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Opioid Receptors: Overview01:22

Opioid Receptors: Overview

307
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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Is Obesity a Factor in Lethal Opioid Toxicity?

Jeremy W S Hunter1, Corinna Van Den Heuvel1, Lilli Stephenson1

  • 1School of Biomedicine, The University of Adelaide, Adelaide, South Australia, Australia.

The American Journal of Forensic Medicine and Pathology
|March 4, 2025
PubMed
Summary

Obesity does not increase sensitivity to fatal opioid toxicity. This study found no link between higher body mass index (BMI) and lower lethal blood opiate levels in overdose deaths.

Keywords:
body mass indexforensic pathologymetabolic dysregulationobesityopioid toxicitysynergism

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Area of Science:

  • Forensic Toxicology
  • Public Health
  • Pharmacology

Background:

  • Global increases in obesity and opioid abuse present significant public health challenges.
  • Respiratory compromise associated with both conditions raises concerns about potential synergistic effects.

Purpose of the Study:

  • To investigate if obesity enhances sensitivity to lethal opioid toxicity.
  • To determine if individuals with higher Body Mass Index (BMI) experience fatal effects at lower postmortem opiate levels.

Main Methods:

  • Retrospective review of 259 heroin or morphine toxicity death cases (2000-2019) from Forensic Science SA.
  • Analysis of postmortem drug levels in relation to Body Mass Index (BMI) categories (obese and morbidly obese).
  • Statistical analysis using Fisher exact test to assess the association between BMI and opiate levels.

Main Results:

  • The average BMI was 26.8, with 50 obese (BMI 30-39.9) and 17 morbidly obese (BMI ≥ 40) decedents.
  • No significant association was found between obesity or morbid obesity and postmortem opiate levels.
  • P-value of 0.30 indicated no statistically significant link between BMI and fatal drug concentrations.

Conclusions:

  • The lack of association suggests that increased BMI does not heighten susceptibility to fatal opioid toxicity.
  • Unidentified metabolic or pharmacokinetic factors in obesity may compensate for the respiratory depressant effects of opioids.
  • Further research is needed to elucidate these compensatory mechanisms.