Jump to content

Methadone

From Wikipedia
(RS)-methadone
group of stereoisomers
Subclass ofketone, tertiary amine, phenyl compound Edit
Chemical formulaC₂₁H₂₇NO Edit
Canonical SMILESCCC(=O)C(CC(C)N(C)C)(C1=CC=CC=C1)C2=CC=CC=C2 Edit
Active ingredient inMethadose, Diskets, Dolophine Edit
World Health Organisation international non-proprietary namemethadone Edit
Medical condition treatedopiate dependence Edit
Physically dey interact plusopioid receptor mu 1 Edit
Legal status (medicine)boxed warning Edit
Pregnancy categoryAustralian pregnancy category C, US pregnancy category C Edit
Get characteristicbitterness Edit
Subject has roleopioid receptor agonist, opioid, antitussive, narcotic, essential medicine Edit

Methadone, dem sell under de brand names Dolophine den Methadose among odas, be a potent synthetic opioid dem use medically to treat chronic pain den opioid use disorder.[1] Dem prescribe for daily use, de medicine dey relieve cravings den opioid withdrawal symptoms.[2] Withdrawal management dey use methadone fi be accomplished insyd less dan a month,[3] anaa e fi be done gradually over a longer period of time, anaa dem simply maintain give de rest of de patient ein life.[1] While a single dose get a rapid effect, maximum effect fi take up to five days of use.[1][4] After long-term use, insyd people plus normal liver function, effects dey last 8 to 36 hours.[1][5] Dem usually dey take methadone by mouth den rarely by injection into a muscle anaa vein.[1]

Side effects be similar to those of oda opioids.[1] Dese frequently dey include dizziness, sleepiness, nausea, vomiting, den sweating.[1][6] Serious risks dey include opioid abuse den respiratory depression.[1] Abnormal heart rhythms sanso fi occur secof a prolonged QT interval.[1] De number of deaths insyd de United States wey dey involve methadone poisoning decline from 4,418 insyd 2011[7] to 3,300 insyd 2015.[8] Risks be greater plus higher doses.[9] Dem make methadone by chemical synthesis den dey act on opioid receptors.[1]

Na dem develop methadone insyd Germany insyd de late 1930s by Gustav Ehrhart den Max Bockmühl.[10][11] Na dem approve am for use as an analgesic insyd de United States insyd 1947, wey e be used insyd de treatment of addiction since de 1960s.[1][12] E dey on de World Health Organization's List of Essential Medicines.[13]

Adverse effects

[edit | edit source]

Adverse effects of methadone dey include:[14]

Withdrawal symptoms

[edit | edit source]

Physical symptoms

[edit | edit source]

Cognitive symptoms

[edit | edit source]
  • Suicidal ideation
  • Susceptibility to cravings[20]
  • Depression[20]
  • Spontaneous orgasm
  • Prolonged insomnia
  • Delirium
  • Auditory hallucinations
  • Visual hallucinations
  • Increased perception of odors (olfaction), real anaa imagined
  • Marked increase in sex drive
  • Agitation
  • Anxiety[20]
  • Panic disorder
  • Nervousness[20]
  • Paranoia
  • Delusions
  • Apathy
  • Anorexia (symptom)

Black box warning

[edit | edit source]

Methadone get de following U.S. FDA black box warning:[22]

  • Risk of addiction den abuse
  • Potentially fatal respiratory depression
  • Lethal overdose insyd accidental ingestion
  • QT prolongation[23]
  • Neonatal opioid withdrawal syndrome insyd kiddies of pregnant women
  • CYP450 drug interactions
  • Risks wen dem use plus alcohol, benzodiazepines, den oda CNS depressants.
  • A certified opioid treatment program be required under federal law (42 CFR 8.12) wen dispensing methadone for de treatment of opioid addiction.

Overdose

[edit | edit source]

Chaw people wey overdose on methadone show sam of de following symptoms:

  • Miosis (constricted pupils)[24]
  • Vomiting[25]
  • Spasms of de stomach den intestines[26]
  • Hypoventilation (breathing wey be too slow/shallow)[24]
  • Drowsiness,[24] sleepiness, disorientation, sedation, unresponsiveness
  • Skin wey be cool, clammy (damp), den pale[24]
  • Blue fingernails den lips[26]
  • Limp muscles,[24] trouble staying awake, nausea
  • Unconsciousness[24] den coma[24]

References

[edit | edit source]
  1. 1 2 3 4 5 6 7 8 9 10 11 "Methadone Hydrochloride". The American Society of Health-System Pharmacists. Archived from the original on 23 December 2015. Retrieved 22 December 2015.
  2. ↑ Joseph H, Stancliff S, Langrod J (2000). "Methadone maintenance treatment (MMT): a review of historical and clinical issues". The Mount Sinai Journal of Medicine, New York. 67 (5–6): 347–364. PMID 11064485.
  3. ↑ World Health Organization (2009). Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings (in English). Geneva: World Health Organization.
  4. ↑ Grissinger M (August 2011). "Keeping patients safe from methadone overdoses". P & T. 36 (8): 462–466. PMC 3171821. PMID 21935293.
  5. ↑ Toombs JD, Kral LA (April 2005). "Methadone treatment for pain states". American Family Physician. 71 (7): 1353–1358. PMID 15832538. Archived from the original on 5 September 2017.
  6. ↑ "Methadone". The Substance Abuse and Mental Health Services Administration. 16 June 2015. Retrieved 14 October 2020.
  7. ↑ "Data table for Figure 1. Age-adjusted drug-poisoning and opioid-analgesic poisoning death rates: United States, 1999–2011" (PDF). CDC. Archived (PDF) from the original on 23 November 2015. Retrieved 22 December 2015.
  8. ↑ Rudd RA, Seth P, David F, Scholl L (December 2016). "Increases in Drug and Opioid-Involved Overdose Deaths - United States, 2010-2015". MMWR. Morbidity and Mortality Weekly Report. 65 (50–51): 1445–1452. doi:10.15585/mmwr.mm655051e1. PMID 28033313.
  9. ↑ Chou R, Turner JA, Devine EB, Hansen RN, Sullivan SD, Blazina I, Dana T, Bougatsos C, Deyo RA (February 2015). "The effectiveness and risks of long-term opioid therapy for chronic pain: a systematic review for a National Institutes of Health Pathways to Prevention Workshop". Annals of Internal Medicine. 162 (4): 276–286. doi:10.7326/M14-2559. PMID 25581257. S2CID 207538295.
  10. ↑ Methadone Matters: Evolving Community Methadone Treatment of Opiate Addiction. CRC Press. 2003. p. 13. ISBN 978-0-203-63309-0. Archived from the original on 23 December 2015.
  11. ↑ Kleiman MA, Hawdon JE (2011). "Diphenypropylamine Derivatives". Encyclopedia of Drug Policy. SAGE Publications. ISBN 978-1-5063-3824-8. Archived from the original on 23 December 2015.
  12. ↑ Kuehn, B. M. (2005). Methadone Treatment Marks 40 Years. JAMA: The Journal of the American Medical Association, 294(8), 887–889. doi:10.1001/jama.294.8.887
  13. ↑ World Health Organization (2021). World Health Organization model list of essential medicines: 22nd list (2021). Geneva: World Health Organization. hdl:10665/345533. WHO/MHP/HPS/EML/2021.02.
  14. ↑ "Methadone Oral: Side Effects". WebMD. Retrieved 25 June 2021.
  15. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 "Methadone". Drugs.com. Archived from the original on 29 July 2017.
  16. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 "Methadone". MedlinePlus. Archived from the original on 27 February 2008.
  17. 1 2 3 4 5 6 7 "Dolophine: Drug Description". RxList. Archived from the original on 3 September 2008.
  18. 1 2 3 4 "Methadone". MedicineNet. Archived from the original on 4 March 2016.
  19. ↑ John J, Amley X, Bombino G, Gitelis C, Topi B, Hollander G, Ghosh J (December 2010). "Torsade de Pointes due to Methadone Use in a Patient with HIV and Hepatitis C Coinfection". Cardiology Research and Practice. 2010 524764. doi:10.4061/2010/524764. PMC 3021856. PMID 21253542.
  20. 1 2 3 4 5 6 7 8 9 10 11 12 13 "National Highway Traffic Safety Administration. Methadone. Drugs and Human Performance Fact Sheets" (PDF). NHTSA.
  21. 1 2 3 4 5 6 7 8 9 Sadovsky R (15 July 2000). "Tips from Other Journals – Public Health Issue: Methadone Maintenance Therapy". American Family Physician. 62 (2): 428–432. Archived from the original on 4 September 2015.
  22. ↑ "Methadone Black Box Warnings - Drugs.com". drugs.com. Retrieved 20 November 2018.
  23. ↑ Tran PN, Sheng J, Randolph AL, Baron CA, Thiebaud N, Ren M, Wu M, Johannesen L, Volpe DA, Patel D, Blinova K, Strauss DG, Wu WW (2020). "Mechanisms of QT prolongation by buprenorphine cannot be explained by direct hERG channel block". PLOS ONE. 15 (11) e0241362. Bibcode:2020PLoSO..1541362T. doi:10.1371/journal.pone.0241362. PMC 7647070. PMID 33157550.
  24. 1 2 3 4 5 6 7 "Methadone (meth' a done)". MedlinePlus. National Institutes of Health. 1 February 2009. Archived from the original on 17 October 2013. Retrieved 23 October 2013.
  25. ↑ "Methadone overdose". MedlinePlus. 3 October 2017.
  26. 1 2 "Methadone overdose: MedlinePlus Medical Encyclopedia". medlineplus.gov (in English). Retrieved 13 November 2021.
[edit | edit source]
  • Tapering off of methadone maintenance
  • DE patent 711069, Dr Max Bockmuehl & Dr Gustav Ehrhart, "Verfahren zur Darstellung von basischen Estern", published 1941-09-25, issued 1941-09-25, assigned to IG Farbenindustrie AG  Archived 13 February 2023 at the Wayback Machine
Dem retrieve am from "https://gpe.wikipedia.org/w/index.php?title=Methadone&oldid=98176"