Meperidine Fentanyl Heroin Morphine

See also Fentanyl Heroin Meperidine Morphine Opium Oxycodone... 

Fentanyl - Heroin Meperidine Methadone Morphine Sufentanil... 

Pruritus has been noted after epidural morphine, pethidine (meperidine), diamorphine (heroin), and fentanyl, with a quoted incidence of 1-100%. Troublesome pruritus occurs in only about 1% of cases (SED-11, 139) (102). In one study of postoperative patients who received morphine 10 mg epidurally, pruritus occurred in 28% of patients (112), but in only 1% of patients in other studies who received 5 and 2 mg morphine (SED-11, 139). With pethidine 50 mg epidurally after cesarean section, there was a 50% incidence of pruritus, but it was troublesome in only one patient (136). Pruritus has been reviewed in relation to parturition (170,171). It occurred in 593 cases (43%) in pregnant women compared with 3050 non-parturients (8.4%). These findings are borne out by other comparative work (137). Pruritus after cesarean section was more common with epidural morphine and fentanyl than with buprenorphine or butorphanol (172). 

Wilson, T.D. Recent advances in HPLC analysis of analgesics. J.Liq.Chromatogr., 1986, 9, 2309-2410 [also antipyrine, aspirin, buprenorphine, butorphanol, codeine, cyclazocine, diamorphine, dihydrocodeine, etorphine, fentanyl, heroin, hydrocodone, hydromorphone, ibuprofen, LAAM, levorphanol, meperidine, methadone, morphine, nalbuphine, naproxen, oxycodone, ox nnorphone, pentazocine, phenacetin, phenazocine, phenylbutazone, propoxyphene, salicylamide, salicylic acid, zomepirac]... 

One might assume that given the widespread prescribing and frequent administration as analgesics of morphine, codeine, their hydro- and oxy-derivatives, meperidine, fentanyl, and tramadol, and the use of heroin (often by intravenous injection) and methadone by addicts, IgE-antibody-mediated allergy to these drugs would not be uncommon. This is not the case. The reasons why are examined below. 

A relatively large number of studies have investigated the effects of opioids on tests requiring focused attention. Morphine (2.5 to 10 mg, IV)185 and propofol (70 mg, IV)193 impaired an auditory simple reaction time test, and fentanyl (1 to 2.5 ng/ml, IV)182 impaired a visual choice reaction time test. Jenkins et al.197 reported that IV (3 to 20 mg) and smoked (2.6 to 10.5 mg) heroin impaired performance on a simple visual reaction time task. However, other studies reported no effect of butorphanol (0.5 to 2.0 mg, IV),186 fentanyl (25 to 100 pg, IV),191 meperidine (0.25 to 1.0 mg, IV),192 and nalbuphine (2.5 to 10 mg, IV)189 on an auditory simple reaction time test. It may be... 

The gold standard of opiate pain relievers is morphine. It was one of the first compounds extracted, isolated, and purified from the opium poppy, and it continues to be one of the most widely used pain relievers today. Morphine and other opiate drugs such as heroin, codeine, oxycodone, and hydrocodone have very similar chemical structures (Figure 3.2). However, other opiates such as fentanyl and meperidine (Demerol) have a slightly different structure (Figure 3.3). 

Full agonists morphine, meperidine, methadone, fentanyl, and heroin... 

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... 

Strong agonists Morphine Heroin, meperidine, methadone Fentanyl. levorphanol... 

The term opioids refers to these and other derivatives of naturally occurring opium (eg, morphine, heroin, codeine, and hydrocodone) as well as new, totally synthetic opiate anaiogs (eg, fentanyl, butorphanol, meperidine, and methadone Table 11-43). A wide variety of prescription medications contain opioids, often in combination with aspirin or acetaminophen. Dextromethorphan (see p 183) is an opioid derivative with potent antitussive but no analgesic or addictive properties. Tramadol (Ultram )... 

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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