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Drug Interactions With New Synthetic Opioids

Fentanyl, fentanyl analogs, and other new synthetic opioids (NSO) have burst onto the illegal drug market as new psychoactive substances (NPS). They are often sold as heroin to unsuspecting users and produce euphoria through their agonist action on μ- opioid receptors. Their high consumption, often...

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Autores principales: Pérez-Mañá, Clara, Papaseit, Esther, Fonseca, Francina, Farré, Adriana, Torrens, Marta, Farré, Magi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6193107/
https://www.ncbi.nlm.nih.gov/pubmed/30364252
http://dx.doi.org/10.3389/fphar.2018.01145
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author Pérez-Mañá, Clara
Papaseit, Esther
Fonseca, Francina
Farré, Adriana
Torrens, Marta
Farré, Magi
author_facet Pérez-Mañá, Clara
Papaseit, Esther
Fonseca, Francina
Farré, Adriana
Torrens, Marta
Farré, Magi
author_sort Pérez-Mañá, Clara
collection PubMed
description Fentanyl, fentanyl analogs, and other new synthetic opioids (NSO) have burst onto the illegal drug market as new psychoactive substances (NPS). They are often sold as heroin to unsuspecting users and produce euphoria through their agonist action on μ- opioid receptors. Their high consumption, often combined with other substances, has led to multiple intoxications during recent years. In some countries, such as the United States, the consumption of opioids, whether for medical or recreational purposes, has become epidemic and is considered a public health problem. Fentanyl analogs are more potent than fentanyl which in turn is 50 times more potent than morphine. Furthermore, some fentanyl analogs have longer duration of action and therefore interactions with other substances and medicines can be more serious. This review is focused on the potentially most frequent interactions of opioid NPS taking into account the drugs present in the reported cases of poly-intoxication, including other illegal drugs of abuse and medication. Substances involved are mainly antidepressants, antihistamines, antipsychotics, benzodiazepines, analgesics, anesthetics, psychostimulants, other opioids, alcohol, and illegal drugs of abuse. The interactions can be produced due to pharmacokinetic and pharmacodynamic mechanisms. Naloxone can be used as an antidote, although required doses might be higher than for traditional opioid intoxications. It is crucial that doctors who habitually prescribe opioids, which are often misused by patients and NPS users, be aware of designer opioids’ potentially life-threatening drug-drug interactions in order to prevent new cases of intoxication.
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spelling pubmed-61931072018-10-25 Drug Interactions With New Synthetic Opioids Pérez-Mañá, Clara Papaseit, Esther Fonseca, Francina Farré, Adriana Torrens, Marta Farré, Magi Front Pharmacol Pharmacology Fentanyl, fentanyl analogs, and other new synthetic opioids (NSO) have burst onto the illegal drug market as new psychoactive substances (NPS). They are often sold as heroin to unsuspecting users and produce euphoria through their agonist action on μ- opioid receptors. Their high consumption, often combined with other substances, has led to multiple intoxications during recent years. In some countries, such as the United States, the consumption of opioids, whether for medical or recreational purposes, has become epidemic and is considered a public health problem. Fentanyl analogs are more potent than fentanyl which in turn is 50 times more potent than morphine. Furthermore, some fentanyl analogs have longer duration of action and therefore interactions with other substances and medicines can be more serious. This review is focused on the potentially most frequent interactions of opioid NPS taking into account the drugs present in the reported cases of poly-intoxication, including other illegal drugs of abuse and medication. Substances involved are mainly antidepressants, antihistamines, antipsychotics, benzodiazepines, analgesics, anesthetics, psychostimulants, other opioids, alcohol, and illegal drugs of abuse. The interactions can be produced due to pharmacokinetic and pharmacodynamic mechanisms. Naloxone can be used as an antidote, although required doses might be higher than for traditional opioid intoxications. It is crucial that doctors who habitually prescribe opioids, which are often misused by patients and NPS users, be aware of designer opioids’ potentially life-threatening drug-drug interactions in order to prevent new cases of intoxication. Frontiers Media S.A. 2018-10-11 /pmc/articles/PMC6193107/ /pubmed/30364252 http://dx.doi.org/10.3389/fphar.2018.01145 Text en Copyright © 2018 Pérez-Mañá, Papaseit, Fonseca, Farré, Torrens and Farré. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pharmacology
Pérez-Mañá, Clara
Papaseit, Esther
Fonseca, Francina
Farré, Adriana
Torrens, Marta
Farré, Magi
Drug Interactions With New Synthetic Opioids
title Drug Interactions With New Synthetic Opioids
title_full Drug Interactions With New Synthetic Opioids
title_fullStr Drug Interactions With New Synthetic Opioids
title_full_unstemmed Drug Interactions With New Synthetic Opioids
title_short Drug Interactions With New Synthetic Opioids
title_sort drug interactions with new synthetic opioids
topic Pharmacology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6193107/
https://www.ncbi.nlm.nih.gov/pubmed/30364252
http://dx.doi.org/10.3389/fphar.2018.01145
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