Hydromorphone Opium

Morphine, when extracted from raw opium and treated chemically, yields the semisynthetic narcotics hydromorphone, oxymorphone, oxycodone, and heroin. Heroin is an illegal narcotic in the United States and is not used in medicine. Synthetic narcotics are those man-made analgesics with properties and actions similar to the natural opioids. Examples of synthetic narcotic analgesics are methadone, levorphanol, remifen-tanil, and meperidine Additional narcotics are listed in the Summary Drug Table Narcotic Analgesics. 

The most widely used agonists in medical practice are the opium alkaloids morphine and codeine. However, semisynthetic derivatives (hydromorphone, oxymorphone, hydrycodon, oxycodone), whose use is even preferred in certain cases, and strong, purely synthetic compounds (methadone, meperidin, fentanyl, sufentanyl, and others) have found wide use. 

Safety and efficacy not established in children for hydromorphone, levorphanol, methadone, morphine, opium, oxymorphone, propoxyphene. 

Natural opium alkaloids codeine phosphate hydromorphone hydrochloride morphine hydrochloride morphine sulfate oxycodone hydrochloride oxymorphone hydrochloride... 

Opium alkaloids and derived phenanthrene alkaloids codeine, morphine, (Avinza, Kadian, MSContin, Roxanol), hydromorphone (Dilaudid), oxymorphone (Numorphan), oxycodone (dihydroxycodeinone, a component of Oxycotin, Oxydose, Oxyfast, Percodan, Percocet, Roxicodone, Tylox)... 

Hydromorphone and its natural opioid relatives have been used to relieve pain, treat a variety of ailments, and create euphoric feelings at least as far back as the time of the ancient Greeks. In early Greek history, the priests controlled the use of opium and ascribed to it supernatural powers. In the fifth century bc, Hippocrates, the father of medicine, dismissed the supernatural attributes of opium. Hippocrates believed opium had cathartic, narcotic, hypnotic, and styptic properties. He believed that all diseases had a natural origin and could be cured by natural therapies. All of the natural opiates historically were derived from opium poppy plants. The liquid extracted from the poppy seeds was typically dried to create a concentrated powder. These extracts were then smoked, eaten, or drank. 

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. 

Benzylpiperazine see Benzylpiperazine/Trifluoro-methylphenylpiperazine Bernice see Cocaine Bhang see Marijuana Bidis see Nicotine Big chief see Mescaline Big d see Hydromorphone BigO see Opium Black see Opium... 

The opium alkaloid thebaine, although therapeutically useless (causes seizures and has little analgetic action), is important as the chemical starting point for the commercial synthesis of methyldihydromorphinone (Metopon), hydrocodone and hydromorphone, oxy-morphone, and the very interesting oripavine compounds (see later). Since these drugs are modifications of a natural alkaloid, they may be referred to as semisynthetic opiates. 

No clinically significant interaction appears to occur between ci-metidine and butorphanol (intranasal), hydromorphone, morphine, pethidine or tramadol between famotidine and hydromorphone or between ranitidine and hydromorphone, morphine, or pethidine. However, isolated reports describe adverse reactions in patients taking methadone, morphine or mixed opium alkaloids with cimetidine, or morphine with ranitidine. 

The best 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, hydromorphone, and heroin, also known as diamorphine. Synthetic narcotics share the structural skeleton of morphine and include dextromethorphan, pentazocine, phenazocine meperidine (pethidine), phentanyl, anfentanil, remifentalin, methadone, dextropropox3q)hene, levoproxyphene, dipipanone, dextromoramide, meptazinol, and tramadol. Thebaine derivatives are also modified narcotics and include oxycodone, oxymorphone. 

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. 

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