Hydromorphone hydrocodone

Smith ML, Hughes RO, Levine B, Dickerson S, Darwin WD, Cone EJ. Forensic drug testing for opiates. VI. Urine testing for hydromorphone, hydrocodone, oxymorphone, and oxycodone with commercial opiate immunoassays and gas chromatography-mass spectrometry, Clin Chem 1995 41 18-26. 

Morphine/codelne (urine) TLC Hydromorphone hydrocodone oxycodone (misidentification). 

The class of narcotic drugs encompasses the opium-derived drugs of morphine, heroin, and codeine (Figure 16.1) as well as other narcotics, such as meperidine, hydromorphone, hydrocodone, and the fentanyl compounds. Because these are highly polar compounds and often require high temperatures for elution, GC is difficult and often demands derivatization. Morphine, for example, because of its amphoteric nature, is not only difficult to extract but must be derivatized to obtain good quantitative data. 

Opioids can be classified according to stractural similarity with morphine in semisynthetic and synthetic derivatives. Structurally similar, semisynthetic morphinelike derivatives as well as stracturally distinct opioids have been synthesized to search for compounds able to improve analgesic effects that minimize side effects. Semisynthetic derivatives include morphine-related agonists (hydromorphone, hydrocodone, oxycodone, oxymorphone, and codeine), and moiphine-related partial agonist and antagonists (buprenorphine, naloxone, and naltrexone). Synthetic derivatives include phenylpiperidines (meperidine and loperamide), diphenylpropylamines (methadone and propoxyphene), and piperidines (fentaityl, alfentanyl, sufentanil, and remifen-tanil) (Dumas and Pollack, 2008). 

Hydromorphone [466-99-9] (31) and hydrocodone [125-29-1] (32) are isomers of morphine and codeine, respectively. Hydromorphone can be prepared by catalytic rearrangement of morphine (49) or by oxidation of the aliphatic hydroxyl group of dihydromorphine (50). Hydrocodone can be similarly prepared. As an antitussive, hydromorphone is several times more active than morphine and hydrocodone is slightly more active than codeine. Hydromorphone has a much higher addiction potential than hydrocodone. 

The inifial sfeps in fhe mefabolism of morphine and codeine by Pseudomonas putida MIO involve oxidafion of fhe C-6 hydroxy group and subsequenf reducfion of fhe 7,8-olefinic bond, forming hydromorphone (dihydromorphinone) and hydrocodone (dihydrocodeinone), respectively (Scheme 4) [52], These products have important industrial appUcations hydromorphone is an analgesic some seven times more potent than morphine [53],... 

Codeine, hydrocodone, morphine, methadone, and oxycodone are substrates of the cytochrome P-450 isoenzyme CYP2D6.47 Inhibition of CYP2D6 results in decreased analgesia of codeine and hydrocodone due to decreased conversion to the active metabolites (e.g., morphine and hydromorphone, respectively) and increased effects of morphine, methadone, and oxycodone. Methadone is also a substrate of CYP3A4, and its metabolism is increased by phenytoin and decreased by cimetidine. CNS depressants may potentiate the sedative effects of opiates. 

Severe pain should be treated with an opioid such as morphine, hydromorphone, methadone, or fentanyl. Moderate pain can be treated effectively in most cases with a weak opioid such as codeine or hydrocodone, usually in combination with acetaminophen. Meperidine should be avoided owing to its relatively short analgesic effect and its toxic metabolite, normeperidine. Normeperidine may accumulate with repeated dosing and can lead to central nervous system side effects including seizures. 

Hydromorphone (I) and hydrocodone (II) belong to the morphine group of drugs and are used invariably in combination with other ingredients in a number of proprietory antitussive and analgesic antipyretic mixtures. However, interest in the pharmacokinetics of hydromorphone and hydrocodone in human subjects required an adequate assay for drug levels in plasma. 

RIA for hydromorphone and hydrocodone are fairly sensitive in the nanogram per millilitre range but essentially require the preparation of a specific antibody. The laid-out RIA method is quite capable of estimating the above drugs within a range of 2.5-20 ng ml 1 using standard 100 pi plasma sample only. 

Hydrochlorobezethylamine, 59 Hydrochlorothiazide, 358 Hydrocodone, 288, 291 Hydrocortisone, 190 Hydrocortisone acetate, 190 Hydroflumethazide, 358 Hydromorphone, 288 Hydroxyamphetamine, 71 Hydroxychloroquine, 342 Hydroxylation... 

Hydrocodone Aspirin (Lortab ASA, others) Hydrocodone Ibuprofen (Vicoprofen) Hydromorphone (Dilaudid) Levorphanol... 

Opioids/narcotics (codeine, fentanyl, hydrocodone, hydromorphone, meperidine [Demerol], morphine, oxycodone [OxyContin], propoxyphene [Darvon]) (see also individual agents in index) Street Names ... 

Hydrocodone (Hycodan), oxycodone (Roxicodone), dihydrocodeine, hydromorphone (Dilaudid), and oxy-morphone (Numorphan) are derivatives of codeine and morphine. All are indicated for the relief of mild to severe pain or for their antipyretic effects they are often used in combination with nonopioid analgesics. The drugs vary in potency, but their pharmacological effects do not differ significantly from those of codeine or morphine. 

Heroin is a Schedule I drug morphine, codeine, fentanyl, hydrocodone, hydromorphone, and oxycodone are Schedule II drugs codeine plus aspirin or acetaminophen is Schedule III propoxyphene is Schedule IV and codeine sold over the counter is Schedule V. 

Other semisynthetic agents are hydromorphone, oxymorphone, oxycodone, hydrocodone, dihydro- ... 

Among the compounds that fall within this class are hydrocodone (e.g., Vicodin), oxycodone (e.g., OxyContin—an oral, controlled-release form of the drug), morphine, fentanyl, codeine, and related medications. Morphine and fentanyl are often used to alleviate severe pain, while codeine is used for milder pain. Other examples of opioids prescribed to relieve pain include propoxyphene (Darvon) hydromorphone (Dilaudid) and meperidine (Demerol), which is used less often because of its side effects. In addition to their effective pain-relieving properties, some of these medications can be used to relieve severe diarrhea (for example, Lomotil, also known as diphenoxylate) or severe coughs (codeine). 

Pharmacokinetic properties Hydrocodone is metabolized by CYP2D6 to the O-desmethyl derivative hydromorphone (Otton et al., 1993). Further steps of metabolization include N-demethylation and glucuronidation. 

Otton, S.V., Schadel, M., Cheung, S.W., Kaplan, H.L., Busto, U.E., Sellers, E.M. CYP2D6 phenotype determines the metabolic conversion of hydrocodone to hydromorphone, Clin. Pharmacol. Ther. 1993, 54, 463-472. 

Hydrocodone is a semisynthetic opioid derived from codeine.18It is utilized as an analgesic and antitussive available for oral administration, often in combination with acetaminophen or ibuprofen. As a rule, potent analgesics containing a methoxyl group at position 3 (e.g., hydrocodone, K, = 19.8 nM) bind the mu receptor relatively weakly, but their O-demethylated metabolites (such as hydromorphone, Kt = 0.6 nM) bind more strangely. As with oxycodone, the possibility exists that some of their ability to relieve pain may actually derive from their active metabolites 48... 

Jones, J., Tomlinson, K., and Moore, C. (2002). The simultaneous determination of codeine, morphine, hydrocodone, hydromorphone, 6-acetylmorphine, and oxycodone in hair and oral fluid. J. Anal. Toxicol. 26 171-175. 

Narcotics are divided into naturally occurring, semisynthetic, and synthetic derivatives. The naturally occurring analgesics consist of morphine and codeine (methylmorphine). The semisynthetic analgesics include hydromorphone (Dilaudid) and hydrocodone (Dicodid). The synthetic analgesics consist of meperidine (Demerol), alphaprodine (Nisentil), methadone (Dolophine), propoxyphene (Darvon), and pentazocine (Talwin). 

Oxycodone is derived from thebaine, one of more than 20 components known as alkaloids (including morphine and codeine) found in opium. In addition to being a primary component of oxycodone, thebaine also is a main ingredient of hydrocodone and hydromorphone, two other prescription painkillers. 

Opioids Morphine Hydromorphone (Dilaudid) Meperidine (Demerol) Methadone Fentanyl Propoxyphene (Darvocet) Hydrocodone (Vicodin) Oxycodone (OxyContin, Percocet)... 

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