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Fentanyl (Duragesic)
(prescription opioids)
Summary of Opioids
Opioids are commonly prescribed because of their effective
analgesic, or pain relieving, properties. Studies have shown that
properly managed medical use of opioid analgesic compounds is safe
and rarely causes addiction. Taken exactly as prescribed, opioids
can be used to manage pain effectively.
Among the compounds that fall within this class—sometimes referred
to as narcotics—are morphine, codeine, and related medications.
Morphine is often used before or after surgery to alleviate severe
pain. Codeine is used for milder pain. Other examples of opioids
that can be prescribed to alleviate pain include oxycodone (OxyContin—an
oral, controlled release form of the drug); propoxyphene (Darvon);
hydrocodone (Vicodin); hydromorphone (Dilaudid); and meperidine
(Demerol), which is used less often because of its side effects. In
addition to their effective pain relieving properties, some of these
medications can be used to relieve severe diarrhea (Lomotil, for
example, which is diphenoxylate) or severe coughs (codeine).
Opioids act by attaching to specific proteins called opioid
receptors, which are found in the brain, spinal cord, and
gastrointestinal tract. When these compounds attach to certain
opioid receptors in the brain and spinal cord, they can effectively
change the way a person experiences pain.
In addition, opioid medications can affect regions of the brain that
mediate what we perceive as pleasure, resulting in the initial
euphoria that many opioids produce. They can also produce
drowsiness, cause constipation, and, depending upon the amount
taken, depress breathing. Taking a large single dose could cause
severe respiratory depression or death.
Opioids may interact with other medications and are only safe to use
with other medications under a physician's supervision. Typically,
they should not be used with substances such as alcohol,
antihistamines, barbiturates, or benzodiazepines. Since these
substances slow breathing, their combined effects could lead to
life-threatening respiratory depression.
Summary
Fentanyl is a powerful synthetic opiate analgesic similar to
but more potent than morphine. It is typically used to treat
patients with severe pain, or to manage pain after surgery. It is
also sometimes used to treat people with chronic pain who are
physically tolerant to opiates. It is a schedule II prescription
drug.
In its prescription form, fentanyl is known as Actiq,
Duragesic, and Sublimaze. Street names for the drug include
Apache, China girl, China white, dance fever, friend, goodfella,
jackpot, murder 8, TNT, as well as Tango and Cash.
Like heroin, morphine, and other opioid drugs, fentanyl works
by binding to the body's opiate receptors, highly concentrated in
areas of the brain that control pain and emotions. When opiate
drugs bind to these receptors, they can drive up dopamine levels
in the brain's reward areas, producing a state of euphoria and
relaxation. Medications called opiate receptor antagonists act by
blocking the effects of opiate drugs. Naloxone is one such
antagonist. Overdoses of fentanyl should be treated immediately
with an opiate antagonist.
When prescribed by a physician, fentanyl is often administered
via injection, transdermal patch, or in lozenge form.
* page last updated 5/19/2008
Source:
National Institute on Drug
Abuse (NIDA), various other sources
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