Methadone medical pain

Pharmacotherapy for chronic pain will encompass the genetic research on the variability of pain expression and the variations in response to analgesic medications. One clinical scenario that presents difficulty in this regard lies in initiating doses of methadone for pain. 

Propoxyphene is a synthetic opioid that is similar to methadone but much less potent. Propoxyphene is the active ingredient in the pharmaceutical products Darvon-N and Darvocet-N. It is used by some physicians to treat severe pain and coughs but is hotly debated as a useful medication. Many doctors refuse to prescribe the drug because of its highly addictive nature. 

In the 1970s, a combination of cocaine, methadone, and alcohol was given to terminal cancer patients. The methadone and alcohol relieved the pain but induced a lethargic and clouded state for the patients. Cocaine was added to make patients more alert. New medications are more effective and cocaine is no longer used for cancer patients. 

Methadone is a synthetic opioid narcotic, discovered in Germany in 1939. Its original name was Ami-don, and it was used mainly as a pain reliever. After the conclusion of World War II, Eli Lilly and other American pharmaceutical companies began clinical trials of the medication, renamed methadone, and also began commercial production. Its original uses in the United States were for pain control and as a component of cough medicine. 

Besides its use in treating illegal opiate addiction, methadone is occasionally used in other areas of medicine. All of the opiates, including methadone, are powerful pain control medications. Since pain is one of the most frequent, and least well-managed, aspects of cancer care, physicians often use multiple medications to try to control cancer pain. Methadone can be given in 20 mg tablets or by intramuscular injection every four to six hours to control moderate to severe cancer pain. Methadone is often used when there is a desire to let the patient sleep because of its high sedating properties. 

In addition to knowledge about the clinical efficacy, adverse effect profile, and likelihood of emergence of resistance, the physician caring for an HIV-infected patient must be well versed in basic pharmacokinetics as well. Such patients are frequently taking multiple medications, including combinations of antiretroviral agents, prophylaxis or treatment for opportunistic infections, and opioid pain medications or methadone for maintenance therapy. 

Racemic methadone (13) continues to be used as a maintenance drug in the treatment of addiction to heroin (14).13 Methadone has also been used in treating severe pain.14 The value in using oral racemic methadone is that it also helps to combat the spread of human immunodeficiency virus by reducing injection of heroin.13 Under medical supervision, the addict can lead a more stable life, but there is a temptation to remain on racemic methadone to avoid the withdrawal symptoms known as cold turkey.13 The illegal use of methadone taken together with other drugs such as benzodiazepines... 

C21H27NO, used medically as an analgesic for chronic pain and also as a substitute for heroin in the treatment of addiction. Methadone is itself addictive and considerable quantities of street methadone are used in the UK. 

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