Opiate-related agents

Opiate-Related Agents Opiate-related agents are synthetic compounds similar to opiates. Side effects are nausea, vomiting, drowsiness, abdominal distention, Tachycardia, paralytic ileus, urinary retention, decreased secretions, and physical dependence. Two common opiate-related agents are ... 

The demonstration of the existence of strictly defined SARs. which is perhaps Ihe most important criterion of drug action at a specific receptor site, has made possible the most important pharmacologic discoveries. For example, the analgesic actions of morphine and related agents, which are indicative of specific receptors, led to die discovery of endogenous opiate peptides, i.e., the leucine and methionine enkephalins and endorphins. 

The illicit use of drugs involves millions of people worldwide and is associated with a variety of medical complications. In recent years the abuse of both heroin and cocaine have produced major medical problems across the globe. Other illicit agents such as barbiturates, ethyl alcohol, amphetamines, and phencyclidine, as well as drug combinations produce medical complications as well, sometimes with renal manifestations (Table 1). An estimate of 5-6 % of new patients beginning treatment for end stage renal disease in the United States appear to have opiate-related kidney disease [1]. 

Long-term use of oral opiates is not routinely recommended for several pharmacologic reasons. Some opioids such as morphine and codeine have the tendency to cause constipation by slowing down the peristaltic action of the bowels, which can also result in a functional ileus. This effect can be minimized by administering laxatives and/or stool softeners in patients who require longer-term opiate therapy. Prokinetic agents may also be helpful in treating opiate-related constipation. 

Morphine and related opiates are known to suppress the cough reflex these compounds have thus been used extensively in antitussive preparations. Since this activity is not directly related to the analgesic potency, the ideal agent is one that has much reduced analgesic activity and thus, presumably, lower addiction potential. The weak analgesic codeine (4) is... 

Loperamide is also structurally related to meperidine and its mechanism of action is like diphenoxylate. Gastointestinal motility is decreased by inhibition of the contractions of the longimdinal as well as the circular musculature, and the activity of this agent is at least in part mediated by its affinity for opiate receptors. As it hardly crosses the blood-... 

While it is true that dextromethorphan is not technically a member of the opiate family, it is distantly related in its chemical composition. Dextromethorphan is created by from levomethorphan, which is classified as an opioid, the synthetic or semi-synthetic relatives of the natural chemical family called the opiates. Levomethorphan has most of the same qualities of all drugs in the opiate and opioid classes. This includes strong suppressive effects on the respiratory system. It is these strong effects on the respiratory system that make dextromethorphan an effective anti-cough agent. Opiate and opioid compounds have anti-cough properties but produce greater overall respiratory depression than dextromethorphan. 

The gas used was stated by the Russian Health Minister to be a derivative of fentanyl, an opiate chemical related to morphine,59 perhaps mixed with other agents (Van Damme, 2002). Reports suggesting that atropine, an antidote to anticholinergic nerve agents, did not reverse the effects of the gas whereas naloxone, an antidote... 

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