Opioid analgesic

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Revision as of 12:40, 14 January 2010 by imported>Howard C. Berkowitz (Are not the chemical classes more significant than natural/semisynthetic/synthetic?)
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Available opioid analgesics

Current opioid analgesics are below[1] Tables of morphine equivalent daily dose and IV to PO conversion are available to help dosing.[1]

Selected opioids[2]
Specific drug Chemical class Receptor action Comments
Naturally occurring opium alkaloids
Morphine morphine mu, kappa (weak)
Codeine morphine mu (partial agonist) Good oral absorption
Semi-synthetic opioids
Diacetylmorphine (heroin) morphine Faster blood-brain transfer than morphine but both produce the same primary active metabolite
Hydrocodone and Oxycodone morphine mu (partial)
Hydromorphone (Dilaudid) morphine mu
Buprenorphine mu, antagonist of delta and kappa
Fully synthetic opioids
Meperidine meperidine accumulates toxic metabolite
Fentanyl meperidine mu Transdermal and transmucosal absorption
Methadone methadone mu Good oral absorption; additional applications in addiction medicine
LAAM methadone mu Not used for analgesia; long-acting blocker of opioid addiction
D-Propoxyphene propoxyphene mu D-propoxyphene primarily analgesic
L-Propoxyphene/dextromorphan propoxyphene mu D-propoxylphene primarily antitussive
Tramadol mu also inhibits norepinephrine reuptake
  1. 1.0 1.1 (2003) “78. Management of Cancer Pain”, Cancer medicine 6. Hamilton, Ont.: BC Decker. ISBN 1-55009-213-8. 
  2. Masters, Susan B.; Katzung, Bertram G.; Trevor, Anthony J. (2009). “Basic Pharmacology of the Opioid Analgesics”, Basic and Clinical Pharmacology, 11th. New York: McGraw-Hill Medical. ISBN 0-07-160405-7.  (Condensed from Table 31-2