Codeine Naltrexone

Alfentanil, codein, dihydromorphine, etor-phine, fentanyl, heroin, hydromorphone, levo-methadone, morphine, oxycodone, pethidine, piritramide, remifentanil, sufentanil, tilidine, tramadol Buprenorphine, pentazocine Naloxone, naltrexone... 

The common side effects of naltrexone are nansea, headache, and dizziness. In addition, naltrexone has the potential for toxic effects on the liver and should not be used in an alcoholic with cirrhosis or other known liver disease. Because it blocks opiate receptors, patients treated with naltrexone are unable to benefit from the analgesic effects of opiates such as codeine or morphine. Naltrexone may increase serum levels of acamprosate in patients taking both medications. 

The most known narcotics are the opium alkaloids such as morphine, codeine, thebaine, papaverine, noscapine and their derivatives and modified compounds such as nalmorphine, apomorphine, apomopholcodine, dihydrocodeine, hydro-morphone and heroine, also known as diamorphine. Synthetic narcotics share the structural skeleton of morphine and include dextromethorphan, pentazocine, phenazocine meperidine (pethidine), phentanyl, anfentaitil, remifentalin, methadone, dextropropoxyphene, levoproxyphene, dipipanone, dextromoramide, meptazinol and tramadol. Thebaine derivatives are also modified narcotics and include oxycodone, oxymorphone, etorphine, buprenorphine, nalbuphine, naloxone or naltrexone. Narcotics can be semi-synthesized or totally synthesized from the morphine and thebaine model. The compounds serve various purposes in clinical practise. 

Drugs in this therapeutic group include morphine, heroin, pethidine, methadone, codeine, dihydrocodeine, dextropropoxyphene, pentazocine, phenazocine, levorphanol and buprenorphine. The principal antagonists in clinical use are naloxone and naltrexone (see Figure 15.3). 

A number of narcotic antagonists based on the morphinan stmcture have been marketed—for example, Buprenorphine, Naloxone, Naltrexone, and Nalorfine. Nalmefene is being pursued for the treatment of alcohol abuse. Oxycodone, and its precursor Codeine, are marketed, with restrictions, as analgesics. noSee Chapter 9, Table 3. 

Morphinans (compactly fused Phe, C6, C5N, C6 and C40 rings) Codeine (opium-derived addictive, analgesic, antitussive, spasmolytic narcotic) morphine (opium-derived addictive, analgesic, antitussive, sedative, spasmolytic narcotic heroin is the semisynthetic diacetate) thebaine (non-analgesic, toxic, convulsant narcotic and semi-synthesis precursor of the anti-addiction drug naltrexone). 

The alkaloid contents of transformed and non-transformed calli were analyzed by an ELISA and an HPLC. The crude extract can be immediately subjected to the ELISA analysis as described above (sections 3.1, 3.4) using morphine-specific monoclonal antibody [145]. The morphine-specific antibody used has a high affinity for morphine, codeine, ethylmorphine, dihydromorphine, and dihydrocodeine, less reactivity with dihydromorphinone, dihydrocodeinone, and norcodeine, but almost no reactivity with naloxone and naltrexone [145]. 

Among opioids, morphinans (Fig. 1) play an important role as therapeutically valuable drugs. Representative examples of the morphinan class of compounds (Fig. 2) are p-opioid analgesic agents for the treatment of moderate-to-severe pain such as naturally occurring alkaloids (e.g. morphine, codeine), semisynthetic derivatives (e.g. oxycodone, oxymorphone, buprenorphine), and synthetic analogs (e.g. levorphanol, butorphanol) [19-21], Codeine is also an effective antitussive drug. The oxymorphone derivatives naloxone [22] and naltrexone [23] represent... 

Full agonists morphine, meperidine, methadone, fentanyl, and heroin Partial agonists buprenorphine, codeine, propoxyphene Mixed agonist-antagonists nalbuphine, pentazocine Antagonists naloxone, naltrexone Phenothiazines chlorpromazine, fluphenazine, thioridazine Others haloperidol, clozapine, risperidone, olanzapine... 

Interfering albuterol, amisulpride, atenolol, chlormezanone, codeine, hsinopril, metformin, naltrexone, phenobarbital, phenol, ranitidine, ritodrine, sultopride, terbutaline, tia-pride, toloxatone... 

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