Opiates medicinal effects

Enkephalins and Endorphins. Morphine (142), an alkaloid found in opium, was first isolated in the early nineteenth century and widely used in patent medicines of that eta. It is pharmacologically potent and includes analgesic and mood altering effects. Endogenous opiates, the enkephalins, endorphins, and dynotphins were identified in the mid-1970s (3,51) (see Opioids, endogenous). Enkephalins and endorphins ate Hsted in Table 9. 

Constipation may be caused by slow intestinal transition, pelvic floor dysfunction, bowel dysfunction like irritable Bowel syndrome and tumours, but can also be secondary to other diseases and life conditions. Many medicines cause constipation, for example opiates, calcium channel blockers and drugs with anticholinergic effects, e.g. antidepressants. 

Opium has been used as a medicine for hundreds of years, inevitably creating countless addicts. Scientists have conducted a never-ending search for effective cures for opium addiction, morphine addiction (morphinism), and heroin addiction. For most of its history, opium addiction was treated as a disease with no cure, and doctors concerned themseives with treating the symptoms of addiction rather than the root cause. As a result, other opiates were used to lessen the effects of withdrawal. The addict is placed on a regimen of opiates that slowly decrease over time, weaning the addict from his or her addiction. This process of treatment is still used today. 

Dey P, Roaf E, Collins S, Shaw H, Steele R Donmall M (2002). Randomized controlled trial to assesss the effectiveness of a primary health care liaison worker in promoting shared care for opiate users. Journal of Public Health Medicine, 24, 38-42... 

Semisynthetic and synthetic narcotics are also produced that have opiate-like effects these narcotics are collectively known as opioids. They include methadone and the designer drug fentanyl, and a number of commonly prescribed medicines such as Darvon, Demerol, Dilaudid, Orlaam, OxyContin, Percodan, Talwin, and Vicodin. 

Several powerful and important modem medicines are derived from opium or are synthetic or semi-synthetic narcotics with opiate-like effects. Many of these medicines are primarily used to control pain but are also used to control coughs and diarrhea, and as anesthesia. 

In medicine today, narcotics are the main drugs used to treat severe pain. They arc also prescribed to control bad coughs. In proper doses, when they are really needed, opiates are safe and extremely effective. Anyone who has experienced the rapid relief of terrible pain by narcotics knows what blessings they can be. By allowing sick and injured people to take their minds off pain, to feci better, to relax and rest, they can also indirectly promote healing. Opium and its derivatives have earned a secure place in treatment over many years of medical experience. 

Opiates are compounds extracted from the milky latex contained in the unripe seed pods of the opium poppy (Papaver somniferum). Opium, morphine, and codeine are the most important opiate alkaloids found in the opium poppy. Opium was used as folk medicine for hundreds, perhaps thousands of years. In the seventeenth century opium smoking led to major addiction problems. In the first decade of the nineteenth century, morphine was isolated from opium. About 20 years later, codeine, one-fifth as strong as morphine, was isolated from both opium and morphine. In 1898, heroin, an extremely potent and addictive derivative of morphine was isolated. The invention of the hypodermic needle during the mid-nineteenth century allowed opiates to be delivered directly into the blood stream, which increases the effects of these drugs. Synthetically produced drugs with morphine-like properties are called opioids. The terms narcotic, opiate, and opioid are frequently used interchangeably. Some common synthetically produced opioids include meperidine (its trade name is Demerol) and methadone, a drug often used to treat heroin addiction. 

The major medical use of opiate drugs is for their analgesic or pain-relieving effects. As noted, opiates have been used for this purpose for centuries and remain the most potent and selective pain relievers known to medicine. Unlike the depressant-type anesthetic drugs discussed earlier, opiate analgesics relieve pain without causing unconsciousness. After receiving moderate doses of opiates, patients remain conscious and arc able to report painful sensations but do not suffer from the pain. 

In Chapter 10 we discussed the use of opiate drugs in the treatment of pain. But the use of opiates for pain relief is usually reserved for severe cases. Many effective painkillers are available over the counter, and aspirin is the most widely known and used. Acetylsalicylic acid (aspirin) is closely related to a chemical found in the bark of the willow and other trees (salicylic acid). Willow bark was used in the treatment of painful conditions and fever by the ancient Greeks and by Native Americans. Salicylic acid was isolated and used as a pain reliever in Europe, but it causes severe stomach distress. It was not until the late 19th century that acetylsalicylic acid was synthesized and named aspirin by the. Bayer Company of Germany. Aspirin has come to be one of the most important drugs in medicine. It is marketed under the brand names Anacin, Bufferin, and Excedrin to name just a few, and more than 10,000 tons of aspirin are consumed in the United States every year (Julien, 2005). 

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. 

The opiates are perhaps the oldest drugs known to man. The use of opium was recorded in China over two thousand years ago and was known in Mesopotamia before that. Over the centuries the crude extract derived from poppies has been widely used as a sedative. A tincture of opium called laudanum was introduced to England and was considered indispensable to medicine. It is ironic that a compound renowned for its sedative effects should have led to at least one war. In the nineteenth century, the Chinese authorities became so alarmed about the addictive properties of opium that they tried to ban all production of it. This was contrary to the interests of the British traders dealing in opium and as a result the British sent in the gunboats to reverse the... 

Some side-effects are not particularly serious. Some, in fact, can be advantageous. Euphoria, for example, is a useful side-effect when treating pain in terminally ill patients. Other side-effects, such as constipation, are uncomfortable but can give clues as to other possible uses for opiate-like structures. For example, opiate structures are widely used in cough medicines and the treatment of diarrhoea. 

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