1Fentanyl is a powerful synthetic opiate analgesic, which has a primary function in managing malignant and non-malignant contractible pain, similar to morphine however it is more potent. This is because fentanyl has an octanol-water partition of 9550 compared to morphine, which has 6. This effectively demonstrates that fentanyl is highly lipid soluble, crossing the blood brain barrier more rapidly. Hence it has a quicker reaction time but at a shorter duration compared to morphine. It is commonly used to treat patients with severe pain or patients experiencing pain after a surgery. Fentanyl can also be used to treat patients with chronic pain that are physically tolerant to opiates. Patients who are not physically tolerant to opiates should avoid the use of fentanyl as this can cause undesirable side effects, which can in some cases be toxic. Fentanyl is registered as a class II prescription drug, meaning that it has a greater potential for being abused, which could have negative implications on a patient’s health as it can result in psychological or physical dependence.1
2Fentanyl binds to the opioid mu-receptor in the central nervous system, reducing the perception of pain but also the emotional response to pain. When applying the fentanyl patch to the skin, a concentration gradient develops, which allows the fentanyl molecules to diffuse down the concentration gradient. A second drug reservoir will then be established in the striatum corneum allowing absorption into the local capillary vasculature, subsequently followed by deliverance into the systemic circulation. The transport of drug across the skin can arise through hair follicle and sweat ducts however the main and targeted route is through passive diffusion, the movement...
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... side effects such as analgesia, alteration in mood and drowsiness can occur. Fentanyl depresses the respiratory centres and the cough reflexes in addition to restricting the pupils. Analgesic blood concentration of fentanyl can cause nausea and vomiting due to stimulation of the chemoreceptor trigger zone.5
5Opioids increase the tone and decrease contractions of smooth muscle in the GI tract. The transit time that fentanyl causes, may be responsible for its constipating effect. The increase in biliary tract pressure, some patients may experience worsening of pain rather than pain relief. Fentanyl may cause orthostatic hypotension and fainting.5
5Overall fentanyl matrix patches are found to be safe and effective for opioid tolerant patients only, and are found to have minimal adverse effects the most common of which are nausea and application site reactions.
If the drug is being used primarily to treat severe pain not responsive to other analgesics, in a painful terminal condition, (such as advanced widespread cancer), it may ...
Intrathecal opiods exert analgesic action by acting on the μ-receptors of the spinal cord. The onset and duration of action are dependent on lipid solubility. Lipid soluble opiods like fentanyl and sufentanil diffuse more from the cerebrospinal fluid into the neural tissue. This translates to faster onset and shorter duration of action when compared to less lipid soluble opiods like morphine, diamorphine and buprenorphine. However, sufentanil has a longer duration of action than fentanyl due to its higher μ-receptors affinity. Very small amounts of opiods are required via the central neuraxial route as compared to the larger doses required systemically. Hence secretion into breast milk is not a cause for concern5.
Opioids work by attaching to specific proteins called opioid receptors which are located on nerve cells in the body. When the drug attaches to the receptors it reduces the perception of pain, but it can also cause drowsiness, altered mental status, and nausea. Misuse and addiction to opioids are very common. According to the CDC 1,000 people annually are seen in the Emergency Department for treatment regarding misuse of prescribed opioids. Addiction occurs in older adults aged forty years and older more frequently than adults aged twenty to
The pain-killing and pleasurable effects of morphine, the narcotic drug derived from the opium poppy, is widely known. Endorphins are surprising similarity to morphine. It was termed “endorphin” from endogenous (meaning within) and morphine (morphine being a pain killer). It was wondered why morphine and other opiate drugs should produce such powerful effects on the nervous system. Thus, the discovery of endorphins followed the realization that certain regions of the brain bound opiate drugs with high affinity. Endorphins were discovered nearly on accident in the 1970s by scientists doing research on drug addiction. It was found that the brain produces its own set of neurochemicals far more powerful than morphine but share the same receptors.
Opioids are potent, addictive drugs that inhibit the transmission of pain signals in the brain.
Opioids are used as pain relievers and although it does the job, there are adverse side effects. Opioids are frequently used in the medical field, allowing doctors to overprescribe their patients. The substance can be very addicting to the dosage being prescribed to the patient. Doctors are commonly prescribing opioids for patients who have mild, moderate, and severe pain. As the pain becomes more severe for the patient, the doctor is more likely to increase the dosage. The increasing dosages of the narcotics become highly addicting. Opioids should not be prescribed as pain killers, due to their highly addictive chemical composition, the detrimental effects on opioid dependent patients, the body, and on future adolescents. Frequently doctors have become carless which causes an upsurge of opioids being overprescribed.
The discovery of morphine, which occurred in 1803, transformed the medical treatment of pain and chronic diseases (Levinthal, 2005). Morphine, a narcotic or opioid, is widely used in the medical field today and is specifically used therapeutically to treat moderate to severe pain in individuals. The most common routes of administration for morphine are oral and intravenous administration (Angel, Gould, Carey, 1998). Morphine acts by binding to opioid receptors in the brain and thus reduces the perception of pain and emotional responses to pain (Weil and Winifred, 2004). The paper will focus on the therapeutic uses of morphine for individuals. Morphine is used in the treatment of pain with individuals suffering from cancer and acute myocardial infarction. Morphine is also administered to patients after surgery to decrease pain and is even thought to decrease the chances of developing posttraumatic stress disorder (Busse, 2006; Herlitz, Hjalmarson, and Waagstein, 1989; Levin, 2010).
And addictive they are. Heroin is perhaps the best-known opioid around, and arguably one of the most addictive substances known to man. Opiates and opioids (hereafter generically referred to as opioids) function by attaching to receptor sites in the body called mu-receptors, which are primarily located in the brain and the digestive system. When these receptors are activated in the brain they produce a rush of euphoria and a groggy state of well being (it is interesting to note that studies have shown that this action does not eliminate the pain one is feeling, but merely changes ones’ perception of it) (Kalb). The body quickly becomes tolerant of this, however, and abuse frequently follows a steep dosage curve requiring that more and more of the drug be taken to produce the same effect. Long-term abusers develop...
Opiates based on their effects on the central nervous system of the body can reduce the pain, change the mood and behavior of the person. Thus, these drug lead to physical and psychological dependence. All around the globe drug abuse and dependence is becoming wildly common. Opioids drug dependence develops due to the effect of these drugs in alteration neurological functioning on temporary basis. Therefor, the risk of developing dependence when opioids are used in regular bases is sufficiently
When it is taken correctly, the side effects are considered to be rare [9]. This type of drug can be a great alternative for pain relief for those who are known to be at a risk of heart disease or even stomach problems [9]. There have also been studies that show improvement for treatment of depression and anxiety [10]. Overall, while acetaminophen is wildly being used, some possible fallbacks should be
Absorption: The absorption of opioid drugs into the bloodstream is largely dependent on the user’s chosen route of administration for the drug, dosage, and lipid solubility. Most NMPOs are taken orally, and absorbed into the bloodstream from the walls of the intestine. Some abusers crush and convert whole prescription pills into powders that can be smoked, snorted, and injected easily. Alternative routes of administration enable users to combine NMPO active compounds with other drugs for a unique effect as well as increase drug bioavailability. More specifically, alternate routes of administration also result in a more potent and rapid delivery of drug to the brain, which often increases to the abuse potential of the drug (Kollins, 2003; Roset et al., 2001). Studies using nationally representative samples report that men use these alternative routes of administration more frequently than women (Back et al., 2011, 2010; Green et al., 2009). Back et al. reported in 2011, a striking disproportion between men and women in this regard; the majority of men in their sample reported frequently snorting (75%), or injecting (42%) their drugs, while women were much more likely to use NMPOs via oral administration (Back, Lawson et al., 2011).
David was going through a very hard transition in his life from the elementary levels of school to high school. Along the way, he started hanging out with the wrong crowd and doing all sorts of drugs like smoking marijuana and drinking alcohol. In his senior year he realized he wanted to do something different with his life and he joined the boxing team and quit drugs, but one Saturday night that all ended. David was offered a patch that was supposed to make him feel an extremely good feeling. He didn't know what was in the patch, but it contained Fentanyl; a special pain reliever for cancer patients. His friend told him to cut open the patch and ingest what was inside. The next morning, David never woke up. Eight weeks later, his mother found out that it was Fentanyl that killed her son (Fox News). "In 2004, there were 15 million Americans ages 12 and up that took Prescription Drugs and used them non-medically "(Prescription Drugs: Their use and Abuse). All around the country more people are being introduced to prescription drugs and addiction rates increase every year. “In 2013 21.5% of high school seniors admitted to taking prescription drugs for a non-medical reason", in 2012 that number was at 21.2% (National Institute on Drug Abuse). That number slowly increases every single year. This problem is really turning into a pandemic in modern society, therefore it is necessary to examine the causes of prescription drug abuse and implement the solutions such as providing more education and regulating the distribution of prescription drugs.
Maisto et al. (2015) consider that opioids are “double-edged swords. On one edge of the
Potent pain medication contains the aspects of utilizing medications such as morphine or demerol, how the medications are dispensed, and t...
Aranella, Cheryl, MD., M.P.H. Use of Opiates to Manage Pain in the Seriously and Terminally Ill Patient. American Hospice Foundation, 2006. Web. 7 November 2011.