Chapter 13: Opiates and Opioid Derivatives

Vocabulary and key concepts from Chapter 13 covering the pharmacology, history, and medical implications of opiates and opioids.

Analgesic Property

The most important characteristic of opiates, which enables the reduction of pain feelings.

Opiates

Natural derivatives directly from opium, including morphine, codeine, and thebaine.

Opium Derivatives

Substances created by slight changes in the chemical composition of morphine, such as heroin, oxycodone (Percocet), and hydrocodone (Vicodin).

Synthetic Opiates

Chemicals that are not related to morphine but produce opiate-like effects.

Morphine and Codeine

The two most potent natural derivatives of opiates.

Heroin (Introduction)

A substance introduced by the Bayer Company in Germany at the end of the 19th century that has a higher potential for abuse than morphine.

Harrison Act ($1914$)

A law that limited opioid prescriptions to legitimate medical use, leading to illegal distribution and a dramatic increase in the price of opium.

Intensity of Response Factors

Variables including the dose taken, method of administration, individual tolerance levels, and the presence of other substances.

Endorphins

"Opiate-like" chemicals produced by the brain, also known as endogenous opioid peptides, which include enkephalins.

Major Effects of Heroin

Symptoms including euphoria, analgesia, and respiratory depression.

Respiratory Depression

The major risk factor of heroin intake that can lead to overdose and death.

Naloxone

A substance that blocks opioid receptors by replacing opiate molecules already present, effectively inactivating the receptors and reversing opioid effects.

Heroin Tolerance

Signs including diminished effects over time and the requirement of higher doses to achieve similar effects.

Heroin Withdrawal

A process starting $4-6$ hours post-dose, peaking over $32-72$ hours, and lasting $5-10$ days, characterized by cravings, diarrhea, and dehydration.

Heroin Lethality

The high risk of death associated with a small ratio of lethal dose (LD) to effective dose (ED).

Primary Medical Uses of Opiates

The relief of pain, treatment of acute diarrhea, and suppression of coughing.

Opioid Misuse Statistics

The finding that roughly $21-29\%$ of chronic pain patients misuse their prescribed opioids.

Fentanyl

A synthetic opioid that is $50-100$ times more potent than morphine and can be consumed via patches, lozenges, or injections.

Fentanyl Effects

Symptoms including euphoria and respiratory depression/arrest, which can lead to coma and death.

Opioid and Sedative Combination

A dangerous mixture that results in an increased risk of respiratory depression, coma, and overdose.