Cancers opiates

All clinically used opiates have the same pharmacology since they all act on the mu receptor with the exception of the kappa agonist, pentazocine. Opiates are used to relieve moderate to severe pain whatever the cause (accidents, post-operative pain, cancer, etc.) and are used pre-, intra- and post-operatively. The mu opiates differ only in potency and pharmacokinetics. Examples are ... 

Cholecystokinin CCKa (CCKj) Human cDNA Anorexia, gastrointestinal disorders, pancreatitis, satiety, diabetes, obesity, nociception, schizophrenia, Parkinson s disease, addiction, cancer Pancreatic enzyme secretion, potentiation of opiate analgesia, gallbladder contraction, gut motility, growth promoting effects on some tumors, dopamine release... 

The following drug classes may have a potential drug interaction with nevirapine Antiarrhythmics, anticonvulsants, antifungals, calcium channel blockers, cancer chemotherapy (cyclophosphamide), ergot alkaloids, immunosuppressants, motility agents, opiate agonists. 

Morphine Morphine (C17H19NO3), a habit forming Class A analgesic drug, is the major bioactive constituent of opium poppy seeds. Like other opium constituents (opiates), e.g. heroin, morphine acts directly on the CNS to relieve pain. Morphine is used for the treatment of post-surgical pain and chronic pain (e.g. cancer pain), and as an adjunct to general anaesthesia, and... 

Ritalin and related generic methylphenidate drugs are available by prescription for individuals six years and older. Ritalin is distributed in 5, 10, and 20 mg tablets. In addition to ADHD, methylphenidate is used for several other medical conditions. It continues to be used for narcolepsy. It has also been used in treating depression, especially in elderly populations. Methylphenidate has been suggested for use in the treatment of brain injury from stroke or brain trauma it has also been suggested to improve appetite and the mood of cancer and HIV patients. Another use is for pain control and/or sedation for patients using opiates. 

Santillan, R., Maestre, J.M., Hurle, M.A., Florez, J. Enhancement of opiate analgesia by nimodipine in cancer patients chronically treated with morphine a preliminary report, Pain 1994, 58, 129-132. 

ChrubasikJ, Chrubasik S, Martin E. Patient-controlled spinal opiate analgesia in terminal cancer. Has its time really arrived Drugs. 1992 43 799-804. 

The opium alkaloids codeine and morphine served as models for the synthesis of naloxone, an important analog used to treat and diagnose opiate addicts, and also led to the discovery of endogenous opioids (enkephalins and endorphins) (see Chapter 47). Similarly, A9-tetrahydro-cannabinol (THC), the component of Cannabis sativa responsible for the central nervous system (CNS) effect, has also been found to reduce nausea associated with cancer chemotherapy (see Chapter 18). 

The opiates and their semi-synthetic and synthetic relatives have long been among the most important drugs in the world because of their ability to alleviate the most severe forms of pain. Often, this pain is derived from invasive surgical procedures or from advanced cancer pain that is virtually unbeatable without this family of drugs. A clear majority of persons who use opiates and their relatives never develop an addiction problem. However, addiction can develop quickly in those with a propensity for these drugs. This can occur in those who are using them for medical reasons as well as in those who use them recreationally. 

Besides its use in treating illegal opiate addiction, methadone is occasionally used in other areas of medicine. All of the opiates, including methadone, are powerful pain control medications. Since pain is one of the most frequent, and least well-managed, aspects of cancer care, physicians often use multiple medications to try to control cancer pain. Methadone can be given in 20 mg tablets or by intramuscular injection every four to six hours to control moderate to severe cancer pain. Methadone is often used when there is a desire to let the patient sleep because of its high sedating properties. 

Morphine has a strong analgesic effect and has been used for the alleviation of postoperative and cancer pain since antiquity, but its use is now restricted because of its drug dependency. Morphine and its homologues were called opiates after opium, which was extracted from poppy seeds. This class of drugs are now termed opioids. 

Inturrisi CE. Opiate analgesic therapy in cancer pain. In Forley KM, ed. Advances in Pain Research and Therapy. Vol. 16. New York Raven Press, 1990 133-154. 

The pharmacological uses of vitamin K are in the treatment of (rare) vitamin K deficiency prophylaxis in newborn infants (Section 5.4.1), and as an antidote to overcome anticoagulant toxicity. Because of its cytoxic effects, menadione has been used in cancer chemotherapy. It also potentiates the analgesic actions of salicylates and opiates, and has been used to enhance pain relief in cancer patients. 

Severe pain in cancer patients that is not adequateiy reiieved by opioid anaigesics aione (combination A/ith opiates)... 

Zenz M, Piepenbrock S, Tryba M. Epidural opiates longterm experiences in cancer pain. Klin Wochenschr 1985 63(5) 225-9. 

Opium poppy Papaver somniferum L., Papaveraceae) is one of the most important medicinal plants and has been cultivated since early centuries. Opium, the dried cytoplasm of a specialized internal secretory system called the laticifer, is normally collected from the unripe capsule. It is the source for the commercial production of medicinally important alkaloids, morphine, codeine, thebaine, noscapine and papaverine [130, 131], Fig. (61). Morphine, which has strong addictive property, is still the most effective analgesic for the treatment of mortal cancer patients in modem medicine. Codeine is commonly used as an antitussive. However, field cultivation of this plant has been limited since 1953 by the United Nations Opium Conference Protocol to prevent narcotic crimes. Therefore, establishing tissue culture technique for the production of morphinan alkaloids seems to be desirable not only for medicinal purpose but also for decreasing abuse of opiates. 

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