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Levorphanol (Levo-Dromoran)
(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.
Levorphanol
Levorphanol (Levo-Dromoran®) is an opioid
medication used to treat severe pain. It is the laevorotary
stereoisomer of the synthetic drug
morphinan (Dromoran) and a pure opioid agonist, first described
in Germany in 1946 as an orally active morphine-like analgesic.
Morphinan is the parent drug and prototype of a large series of
opioid and/or NMDA pure or mixed agonists used in medicine including
nalbuphine,
butorphanol,
dextromethorphan, and others. One morphinan derivative,
cyclorphan was found to be highly hallucinogenic and
psychotomimetic and have other untoward effects and of course was
never marketed as an analgesic.
Levorphanol has the same properties as
morphine with respect to the potential for
habituation,
tolerance,
physical dependence and
withdrawal syndrome.
It has a mean duration of action from 4-7 hours and for this reason
is useful in palliation of chronic pain and similar conditions.
* page last updated 5/20/2008
Source:
National Institute on Drug
Abuse (NIDA), various other sources
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