Synthetic Demerol

The two most common analogs of meperidine used as recreational drugs are l-methyl-4-phenyl-4-propionoxypiperidine (MPPP) and l-[2-phenylethyl]-4-acetyloxypiperdine (PEPAP). These compounds have a number of street names, including new heroin, synthetic heroin, synthetic Demerol, and China White. MPPP and PEPAP have pharmacological effects similar to those of heroin, hut more pronounced, producing a sense of euphoria and release from the real world. MPPP, for example, is three times as potent has heroin. 

Phenylpiperidines (meperidine-like agonists) Meperidine (Demerol, various) Synthetic ++ +... 

Designated synthetic drugs levomethadyl (Orlaam), meperidine (Demerol), methadone, levorphanol (Levo-Dromoran), fentanyl (Sublimaze, Duragesic, Actiq), alphaprodine, alfentanil (Alfenta), sufentanil (Sufenta), remifentanil (Ultiva)... 

There are also synthetic narcotics that are not related to opium. They include the painkiller Meperidine (best known as Demerol), which is frequently given during childbirth or after surgery. Patients can become dependent on these drugs depending on the dose, length of time taken, and individual chemistry. 

During the late 1930s some 4-phenylpiperidine derivatives were examined as potential spasmolytics on the basis of their chemical relationship to atropine. The antinociceptive properties of one member, ethyl 1-methyl-4-phenyl-piperidine-4-carboxylate, was detected in screening tests and the compound was subsequently introduced into clinical use by Eisleb and Schaumann in 1939. The compound, well known as pethidine in Europe and meperidine in North America (proprietary names include Demerol, Dolantin, and Dolosal), was soon in widespread use for the relief of pain, and it is remarkable how pethidine, the original non-opioid-derived opioid analgesic, has retained its popularity for many years in the face of competition from other synthetic analgesics introduced since 1939. 

Narcotics Demerol Morphine Heroin Others Natural and synthetic opioids analgesics Oral or injected (IM, IV) Relaxation euphoria feelings of tranquility prevent onset of opiate withdrawal Physical dependence respiratory depression high potential for death due to overdose See Chapter 14... 

Narcotics are divided into naturally occurring, semisynthetic, and synthetic derivatives. The naturally occurring analgesics consist of morphine and codeine (methylmorphine). The semisynthetic analgesics include hydromorphone (Dilaudid) and hydrocodone (Dicodid). The synthetic analgesics consist of meperidine (Demerol), alphaprodine (Nisentil), methadone (Dolophine), propoxyphene (Darvon), and pentazocine (Talwin). 

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. 

Drugs derived from morphine and other opium compounds are called opiates. Today, many hundreds of opiates are known some are semisynthetic derivatives, like heroin, and others are purely synthetic, like Demerol. In general, all of the opiates produce similar effects. They differ from each other in potency, in duration of action, in how active they are by mouth, and in how much mood change they cause relative to their physical effects. Opiates that arc more potent, shorter-acting, and more active by injection lend themselves more easily to abuse. 

One of the commonest drugs usL d to treat intestinal cramps and diarrhea is Lomotil, a combination of a synthetic opiate called diphenoxylate and atropine, one ot the constituents of nigiushade plants. Both of these drugs reduce the movement of the intestines by paralyzing the nerves that control them. Diphenoxylate is a close chemical relative of meperidine (Demerol), one of the strong medical narcotics. Like its relative, diphenoxylate can cause depression ot the nervous system that may he intensified by simultaneous use of other depressants. It can also cause euphoria and dependence. Many patients who take Lomotil for intestinal upset experience narcotic effects on mood but have no idea they are using an opiate. 

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. 

Heroin was first synthesized from morphine over a century ago. Since then, it has become one of the most abused substances. Research into why it produces such powerful effects has led to the discovery of specific opiate receptors and endogenous opioids (enkephalins and endorphins). These peptides appear to be neurotransmitters involved with the sensation of pain and pleasure. A number of opiates and synthetic opioids are available and can lead to dependency, including morphine, heroin, propoxyphene (Darvon), methadone, meperidine (Demerol), pentazocine (Talwin), hy-dromorphone (Dilaudid), oxycodone (Percodan), and hydrocodone (Vicodin, Damason-P), and codeine. 

Codeine (sulfate, phosphate), CSS II Hydromorphone HC1 (Dilaudid) CSS II Levorphanol tartrate (Levo-Dromoran) CSS II Meperidine (Demerol) Synthetic narcotic CSS II Fentanyl (Duragesic, Sublimaze) CSS II... 

Meperidine (Demerol) Synthetic narcotic CSS II For moderate pain... 

Classify Demerol, a synthetic narcotic analgesic, as a primary, secondary, or tertiary amine. 

---