Vomiting methadone

There are two main treatments for the opiate withdrawal syndrome. One is replacement therapy with methadone or other X agonists that have a longer half-life than heroin or morphine, and produce mild stimulation rather than euphoria. They also produce cross-tolerance to heroin, lessening heroin s effect if patients relapse. Withdrawal is also treated with the 0C2 agonist clonidine, which inhibits LC neurons, thus counteracting autonomic effects of opiate withdrawal — such as nausea, vomiting, cramps, sweating, tachycardia and hypertension — that are due in part to loss of opiate inhibition of LC neurons. 

Nausea is a side effect of all opiates. People who take opiates, including methadone, for a long period of time generally develop a tolerance for its nauseating effects. Vomiting, while common with other opiates such as heroin, is actually a rare side effect of methadone. These side effects are due to the stimulation by opiates of the part of the brain called the medulla, which controls nausea and vomiting. 

Another important side effect of all opiates on the central nervous system is respiratory depression. This is caused by an inhibitory effect on the brain stem, which is the part of the brain that controls breathing and other involuntary bodily systems such as heart beat, etc. Like nausea and vomiting, people who take methadone and other opiates normally develop a tolerance to this side effect. However, even people who have taken methadone for a long period of time can develop major respiratory depression. 

Almost all people on methadone who decide to go off of it will have withdrawal symptoms such as anxiety, depression, nausea/vomiting, and difficulty sleeping. To help minimize these effects of methadone detoxification, a gradual reduction in the dose of methadone is done over a long period of time to help the person adjust to not having methadone in their body. 

SAFETY PROFILE Poison by ingestion, intraperitoneal, intravenous, subcutaneous, and intraduodenal routes. Human systemic effects coma, nausea or vomiting, respiratory changes, respiratory depression, somnolence. An experimental teratogen. Experimental reproductive effects. Caution Abuse leads to habituation or addiction. When heated to decomposition it emits toxic fumes of NOx. See also METHADONE HYDROCHLORIDE. 

Vomiting is fairly common with methadone (though somewhat less so than with morphine) especially if the patient is ambulant, and sedation is less. 

In the last 32 there were significant improvements in pain intensity, nausea and vomiting, constipation, and drowsiness, with a 20% increase in methadone dose over and above the recommended starting dose. 

Opiates Pupillary constriction, constipation, drowsiness, coma, slurred speech, respiratory depression, Flu-like muscle aches, nausea or vomiting, yawning, piloerection, [animation, rhinorrhea, fever, insomnia, pupillary dilation Opiates receptors, locus cereleus pathway (noradrenergic) Naloxone (short half-life), naltrexone (longer half-life), donidine (ease withdrawal), methadone, LAMM (Levo-ac-aretyl-methadol) substitute addictions,longer withdrawal period Males > Females 3 1 TB, AIDS, hepatitis, pulmonary hypertension, pneumonia... 

Methadone hydrochloride is an opioid analgesic that relieves pain by stimulating opiate receptors in the CNS it also causes respiratory depression, peripheral vasodilation, inhibition of intestinal peristalsis, sphincter of Oddi spasm, stimulation of chemoreceptors that cause vomiting and increased bladder tone. 

Naioxone (Narcan) Surmountably blocks opioid receptors. Has no effect in narcotic-free persons. Treatment of narcotic overdose. Diagnostic agent (for evaluation of addiction) in methadone programs. To reduce postoperative respiratory depression. Induces narcotic withdrawal syndrome (appetite loss, muscle contraction, fever/chills, restlessness, cardiovascular and respiratory symptoms, nausea,vomiting, diarrhea.)... 

In an open study in 21 opioid-tolerant patients with severe cancer pain who were switched to methadone, the switch was generally well tolerated only one patient required treatment withdrawal, because of respiratory depression [85 ]. Drowsiness was one of the most frequent adverse effects (in six patients) but it was of moderate intensity and responded to dosage reduction. Constipation was problematic in six. Other effects included nausea and vomiting (n = 2), sweating (n = 2), and confusion (n = 1). 

---