Opioids I Flashcards
what are the opioids?
opioid is a term used to describe compounds both natural AND synthetic that have properties similar to opium or morphine (OPIATE refers to only naturally occurring compounds)
- they are powerful analgesics
- have a dramatic effect on the affective component of pain (anxiety, worry, uneasiness etc..)
- referred to as narcotics because it causes sleep
- Canada is the top opioid using countries per capita
What are three basic types of opioids
- Natural opiates –> opium from poppies contains natural opiates (example includes morphine and codeine)
- Semi-synthetic opioids –> modified versions of naturally occurring chemicals found in poppies (i.e. heroin and oxycodone)
- Synthetic opioids –> entirely artificial but bind to opioid receptors (i.e fentanyl and methadone)
How is opium harvested?
main source is a particular poppy called the PAPAVER SOMNIFERUM
opium is the SAP of the plant
plant makes drug in only 10 days of its life cycle between petals dropping and seed pod maturing
this is a traditionally labour intensive job with workers scratching the seed pods in the evening so that the white sap (latex) oozes out overnight and oxidizes into brown gummy substance
they take this substance and scrape it off by hand and compress it to make opium
what is opium’s properties?
its a mixture of narcotic and non-narcotic alkaloids
there are two major narcotic components: morphine (10%) and codeine (0.5%)
morphine is 10 fold more potent than opium itself
codeine is converted into morphine in the liver and in the brain
if the enzyme that converts codeine to morphine is deficient (6-10% caucasians) then codeine produces no effect to those people
if overactive because of multiple copies of the genes (2% of population), you can get morphine intoxication from codeine use
what is heroin and its properties?
in 1874, two acetyl groups were added to morphine by Bayer (a drug company) giving it diacetylmorphine and brand name Heroin
two acetyl groups make heroin 10 times more lipid soluble than morphine and more potent
gets to the brain faster and higher in concentrations
the acetyl groups just act as a fast vehicle to get the morphine into the brain and once they are there, the acetyl groups disconnect (metabolically removed in the brain) and morphine can just bind to its receptors
what is the deacteylation of heroin?
in the brain one acetyl group is metabolized at a time
you end up with a mixture of 6-monoacetyl-morphine (6-MAM) and 3-monoacetlymorphine (3-MAM)
6-MAM binds to mu receptors and is psychoactive said it produces a different high than heroin, 3-MAM does not
both are then converted into morphine
6-MAM can only be produced from heroin and so is used in legal cases to prove heroin use
What is Krokodil/desomorphine?
Like heroin, it is another semisynthetic opioid
- it surfaced Russia several years ago
- attempted to make a more potent drug from a less potent derivative (codeine)
- codeine, red phosphorous, gasoline, iodine and hydrochloric acid were used to generate desomorphine
desomorphine is more potent than morphine because its more lipophilic (bc of its missing hydroxyl group)
final product is an unfiltered suspension that is injected IV
damages blood vessels, muscles and bones and produces abscesses, gangrene, large scale necrosis crocodile-like skin
What is oxycodone? What is the tablet that its made?
one of the most abused prespcription drugs
Oxycontin is a tablet that contains many times the amount of oxycodone as a regular tablet and it was designed as a time-release formula
can be crushed, dissolved then injected or crushed and snorted
what is Percocet?
oxycodone mixed with acetwaminophen
what is Percodan?
oxycodone mixed with asprin
what happened during the Oxycontin reformulation and what is is OXYNEO?
oxyneo replaced oxycontin
the new pills contained polyethylene oxide, a hydrophilic polymer and oxyneo is forumulated so that if the user crushes it into powder to snort, it forms a gummy Gell when exposed to fluid
this change to oxycontin is dangerous because it made people go back to using heroin instead of a regulated drug
what is fentanyl?
is a synthetic opioid
often made into pills that look like 80mh oxycontin tablts
it is found in cocaine and even pills marketed as ecstasy tablets
655 deaths in Canada from 2009 and 2015 from fentanyl and increased 26 fold in Alberta this period
has a much greater respiratory depression effect than other opiods
what are some effects of fentanyl?
- used as a surgical anesthetic and analegsic but also in lollipops and skin patches
100X more potent than morphine, and 4-50X more potent than heroin due to high lipophilicity - lethal in individuals who think they are injecting heroin or taking oxycontin
more popular since oxyNeo formulation appeared
What are some fentanyl derivatives? how potent are they?
modification of fentanyl has lead to increased affinity for mu receptors and increased ability to enter the brain = higher potency
Carentanil is used as a traditional elephant tranquilizer and 100 times more potent than fentanyl; 20 micrograms of it can be fatal
3-methylfentanyl
10-15 times more potent than fentanyl
What are some general opioid abuse effects?
- intense euphoria, drowsiness, mental clouding, sleepy sensation “nodding”
- a “rush” when taking IV –> large amounts enter brain rapidly “body orgasm” and the effect can follow sedation for about an hour
- analgesia may last up to 3 to 5 hours
