Opioids

Question 1

Phenanthrene

Answer 1

(or natural opioids), are morphine and morphine derivatives and are all aromatic

Question 2

Synthetic opioids

Answer 2

fentanyl and fentanyl-like compounds

Question 3

2 Types of Opioids:

Answer 3

1. Phenanthrene
2. Synthetic

All interact (bind) with the opioid receptors, predominantly mu opioid receptors, but other opioid receptors exist. Most are agonists, but some are antagonists

Question 4

Examples of Phenanthrene Opioids

Answer 4

Question 5

Piperidine Opioids

Answer 5

Note the presence of the phenyl and piperidine rings. Note the similarity of each compound except for the lipophilic side group.

Question 6

Piperidine ring

Answer 6

Question 7

Strengths of Fentanyl, Sufentanyl and Alfentanil

Answer 7

• Fentanyl is 100x more potent than morphine.
• Sufentanil is approx 1000x more potent than morphine.
• Alfentanil less potent than fentanyl.
• All are more lipid soluble than morphine.

Question 8

Remifentanil and remifentanil metabolism

Answer 8

Remifentanil is short-acting due to its rapid metabolism by ester hydrolysis and to a lesser degree by N-dealkylation.

Question 9

Chemical description of fentanyl

Answer 9

SUBLIMAZE (fentanyl citrate) injection is a potent narcotic analgesic. Each milliliter of solution contains fentanyl citrate equivalent to 50 mcgm of fentanyl base, adjusted to pH 4.0-7.5 with sodium hydroxide.

Question 10

Meperidine

Answer 10