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Pharmacological Aspects of Over-the-Counter Opioid Drugs Misuse

Several over-the-counter (OTC) drugs are known to be misused. Among them are opioids such as codeine, dihydrocodeine, and loperamide. This work elucidates their pharmacology, interactions, safety profiles, and how pharmacology is being manipulated to misuse these common medications, with the aim to...

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Autores principales: Sobczak, Łukasz, Goryński, Krzysztof
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7504308/
https://www.ncbi.nlm.nih.gov/pubmed/32867117
http://dx.doi.org/10.3390/molecules25173905
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author Sobczak, Łukasz
Goryński, Krzysztof
author_facet Sobczak, Łukasz
Goryński, Krzysztof
author_sort Sobczak, Łukasz
collection PubMed
description Several over-the-counter (OTC) drugs are known to be misused. Among them are opioids such as codeine, dihydrocodeine, and loperamide. This work elucidates their pharmacology, interactions, safety profiles, and how pharmacology is being manipulated to misuse these common medications, with the aim to expand on the subject outlined by the authors focusing on abuse prevention and prevalence rates. The reviewed literature was identified in several online databases through searches conducted with phrases created by combining the international non-proprietary names of the drugs with terms related to drug misuse. The results show that OTC opioids are misused as an alternative for illicit narcotics, or prescription-only opioids. The potency of codeine and loperamide is strongly dependent on the individual enzymatic activity of CYP2D6 and CYP3A4, as well as P-glycoprotein function. Codeine can also be utilized as a substrate for clandestine syntheses of more potent drugs of abuse, namely desomorphine (“Krokodil”), and morphine. The dangerous methods used to prepare these substances can result in poisoning from toxic chemicals and impurities originating from the synthesis procedure. OTC opioids are generally safe when consumed in accordance with medical guidelines. However, the intake of supratherapeutic amounts of these substances may reveal surprising traits of common medications.
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spelling pubmed-75043082020-09-24 Pharmacological Aspects of Over-the-Counter Opioid Drugs Misuse Sobczak, Łukasz Goryński, Krzysztof Molecules Review Several over-the-counter (OTC) drugs are known to be misused. Among them are opioids such as codeine, dihydrocodeine, and loperamide. This work elucidates their pharmacology, interactions, safety profiles, and how pharmacology is being manipulated to misuse these common medications, with the aim to expand on the subject outlined by the authors focusing on abuse prevention and prevalence rates. The reviewed literature was identified in several online databases through searches conducted with phrases created by combining the international non-proprietary names of the drugs with terms related to drug misuse. The results show that OTC opioids are misused as an alternative for illicit narcotics, or prescription-only opioids. The potency of codeine and loperamide is strongly dependent on the individual enzymatic activity of CYP2D6 and CYP3A4, as well as P-glycoprotein function. Codeine can also be utilized as a substrate for clandestine syntheses of more potent drugs of abuse, namely desomorphine (“Krokodil”), and morphine. The dangerous methods used to prepare these substances can result in poisoning from toxic chemicals and impurities originating from the synthesis procedure. OTC opioids are generally safe when consumed in accordance with medical guidelines. However, the intake of supratherapeutic amounts of these substances may reveal surprising traits of common medications. MDPI 2020-08-27 /pmc/articles/PMC7504308/ /pubmed/32867117 http://dx.doi.org/10.3390/molecules25173905 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Sobczak, Łukasz
Goryński, Krzysztof
Pharmacological Aspects of Over-the-Counter Opioid Drugs Misuse
title Pharmacological Aspects of Over-the-Counter Opioid Drugs Misuse
title_full Pharmacological Aspects of Over-the-Counter Opioid Drugs Misuse
title_fullStr Pharmacological Aspects of Over-the-Counter Opioid Drugs Misuse
title_full_unstemmed Pharmacological Aspects of Over-the-Counter Opioid Drugs Misuse
title_short Pharmacological Aspects of Over-the-Counter Opioid Drugs Misuse
title_sort pharmacological aspects of over-the-counter opioid drugs misuse
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7504308/
https://www.ncbi.nlm.nih.gov/pubmed/32867117
http://dx.doi.org/10.3390/molecules25173905
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