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PubMed1978

Dental implications of narcotic addiction.

The nature of dental problems peculiar to narcotic addicts is discussed. A high caries rate and severe periodontal disease are common and can be attributed to a combination of dietary considerations and oral neglect. Loss of customary accompanying analgesia may complicate an attempted withdrawal programme. An approach to dental treatment of the narcotic addict is suggested. This should aim primarily at relief of pain and be carried out in consultation with the drug treatment centre. The risk posed by these patients of transmission of Hepatitis B is emphasized.

Dental Caries↗
PubMed1984

The peripheral narcotic antagonist N-allyl levallorphan-bromide (CM 32191) selectively prevents morphine antipropulsive action and buprenorphine in-vivo binding in the rat intestine.

The assumed low ability of the quaternary narcotic antagonist N-allyl levallorphan-bromide (CM 32191) to cross the blood-brain barrier and its selectivity in relieving the peripherally-elicited antipropulsive action of morphine while preserving analgesia has been tested. To ascertain the extent of penetration of CM 32191 into the cns, its relative potency in preventing the in-vivo binding of high specific activity [3H]buprenorphine in the rat cns and small intestine was compared. Pretreatment was with CM 32191 at 16, 30 or 60 mg kg-1 s.c., 20, 60 or 120 min before buprenorphine, the concentrations of which in cerebrum and spinal cord were comparable with control values, but were consistently reduced in the intestine (longitudinal muscle with attached myenteric plexus). Pretreatment with naloxone (20 min, 0.5 or 1 mg kg-1 s.c.) lowered buprenorphine binding in intestine and cns. Neither narcotic antagonist produced significant changes in buprenorphine plasma concentrations. The peripheral selectivity of CM 32191, methyl naloxone and naloxone was examined by investigating in the same rats nociception in the hot plate (central opiate-sensitive mechanism) and the transit of a charcoal meal along the small intestine (local opiate-sensitive mechanism). Both effects were inhibited by morphine (5 mg kg-1 i.v.). Naloxone (10 min pretreatment, 0.5 or 1 mg kg-1 s.c.) did not selectively antagonize intestinal action of the morphine since the relief of charcoal transit inhibition was consistently associated with complete loss of analgesia.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1976

Analgesia mediated by a direct spinal action of narcotics.

Narcotic analgetics administered directly into the spinal subarachnoid space of the rat via a chronically inserted catheter produce a potent analgesia that can be antagonized by naloxone. The narcotics, acting only at the spinal level, changed cord function to block not only spinal reflexes but also the operant response to painful stimuli.

Analgesia↗
PubMed2003

Naloxone for narcotic exposed newborn infants: systematic review.

BACKGROUND: Naloxone, a specific opiate antagonist, is available for the treatment of newborn infants with respiratory depression that may be due to transplacentally acquired opiates. AIMS: To determine if this treatment has any clinically important benefits, and whether there are any harmful effects. METHODS: Randomised controlled trials that compared naloxone with placebo or no drug for newborn infants with transplacental exposure to narcotics were systematically reviewed. The Cochrane Controlled Trials Register (CCTR; 2002, Issue 3), Medline (1966 to June 2002), and Embase (1988 to June 2002) were searched. Data were extracted, analysed, and synthesised using the standard methods of the Cochrane Neonatal Collaborative Review Group. RESULTS: Nine trials were found that fulfilled the specified inclusion criteria. Although there was evidence that naloxone increased alveolar ventilation, no data were found on the specified primary outcomes of this review: the need for assisted ventilation or admission to a neonatal unit. CONCLUSIONS: There is a need for a randomised controlled trial to determine if naloxone confers any clinically important benefits on newborn infants with respiratory depression that may be due to transplacentally acquired narcotic.

Analgesia, Obstetrical↗
PubMed1975

Inhibition of ADH release in the rat by narcotic antagonists.

The diuretic action of two new narcotic antagonists, oxilorphan and butorphanol, was studied in rats heterozygous for hereditary hypothalmic diabetes insipidus. Both drugs caused a prompt increase in urine volume and a decrease in urine osmolality with an associated decrease in urinary ADH excretion. The effects appeared to be dose related and of short duration. Tolerance to butorphanol administration was evident on repeated daily injections. The diuretic effect was not associated with alternation in creatinine excretion, but butorphanol resulted in decreased osmolal, sodium and potassium excretion. Butorphanol prevented the expected rise in urine osmolality and ADH excretion due to 31 h of dehydration. Oxilorphan did not interfere with the ability of administered ADH to cause an antidiuresis. The data indicate that these narcotic antagonists cause a diuresis by inhibiting ADH release from the neurohypophysis.

Animals↗
PubMed1989

Clinical pharmacology of mivacurium chloride (BW B1090U) in children during nitrous oxide-halothane and nitrous oxide-narcotic anesthesia.

We determined the dose-response relationships of mivacurium (BW B1090U) in children (2-10 years) during nitrous oxide-halothane anesthesia (0.8% end-tidal) and during nitrous oxide-narcotic anesthesia. Neuromuscular blockade was monitored by recording the electromyographic activity of the adductor pollicis muscle resulting from supramaximal stimulation at the ulnar nerve at 2 Hz for 2 seconds at 10-second intervals. To estimate dose-response relationships, for each anesthetic background four subgroups of nine patients received single bolus doses of 20-120 micrograms/kg mivacurium. The ED50 and ED95 (estimated from linear regression plots of log-dose vs. probit of effect) were 52 micrograms/kg and 89 micrograms/kg during halothane anesthesia and 62 micrograms/kg and 103 micrograms/kg during narcotic anesthesia. Nine additional patients in each anesthetic group received 250 micrograms/kg mivacurium. Three of the 18 patients given 250 micrograms/kg mivacurium developed cutaneous flushing; in one of these mean arterial pressure decreased 32% for less than 1 minute; no significant changes in heart rate occurred. With the increase in mivacurium dose from 120 micrograms/kg to 250 micrograms/kg the times to onset of 90% and maximum neuromuscular block decreased by 0.5 to 1 minute, and the times to recovery of neuromuscular transmission to 5% (T5) or 25% (T25) increased by 2-4 minutes. The recovery index (T25-75) in patients anesthetized with halothane was 4.3 +/- 1.5 minute (mean +/- SD); the time to complete recovery (T4:1 greater than or equal to 0.75) was 19.8 +/- 7.4 minutes.

Age Factors↗
PubMed1989

Smoking and narcotics use among chronic pain patients.

Among 137 noncancer patients having pain for more than 6 mo. and being within 30 to 69 yr. of age, narcotics users were evenly distributed but tobacco smokers were significantly more likely than nonsmokers to use narcotics.

Adult↗
PubMed1977

Use of difenoximide (SC-26100) for narcotic detoxification: a preliminary tolerance and efficacy study.

Difenoximide (SC-26100) is closely related to the antidiarrheal agent, diphenoxylate, which is a chemical congener of meperidine. It has been shown to have a greater ability than methadone to suppress opiate withdrawal in addicted mice, and it has produced less physical dependence than morphine and methadone in laboratory animals. In this study difenoximide was administered to nine active heroin addicts. A dose of 4 mg administered 4 times per day for 3 days effectively suppressed opiate withdrawal, while a dose of 8 mg produced symptoms resembling those of narcotic excess in subjects who had recently self-administered heroin. No side effect were observed at the therapeutic dosage level, and the drug was well accepted by subjects. Difenoximide was shown to be a potentially useful narcotic treatment agent in this impatient study.

Adolescent↗
PubMedDate not supplied

An analysis of federal narcotic detoxification policy: implications for rehabilitation.

The current federal narcotic detoxification policy, limiting such treatment to 21 d, is analyzed with respect to its impact on the success rate for complete withdrawal. Data are drawn from an historical review of American Medical Association statements on narcotic addiction and a review of empirical data on short- and long-term detoxification. The 3-week limit is shown to interfere with achieving successful detoxification rates, although it continues to guide federal detoxification policy. Empirical evidence supports long-term detoxification that recognizes other factors as also having a therapeutic effect. It is time to revise the current federal policy to more accurately reflect the progress made in long-term care.

Drug and Narcotic Control↗
PubMed1978

Relationship between locus of control and drug effects in users of narcotics, stimulants, hypnotic-sedatives, and hallucinogens.

A test is made of the hypothesis that the subjective effects of narcotics lead to an internal locus of control orientation. No support is evident. Similar findings are given for users of stimulants. As an aside to the major focus of the study, a test of locus of control differences between users of narcotics, stimulants, hypnotic-sedatives, and hallucinogens is given, with no differences being found.

Amphetamines↗
PubMed1975

Narcotic antagonist activity of several metabolites of naloxone and naltrexone tested in morphine dependent mice (38558).

A rabbit liver enzyme system was used to produce the 6beta-OH reduced metabolites of naloxone and naltrexone. GC analysis indicated the presence of some 6alpha-OH metabolite in these samples. The narcotic antagonist activity of these 6beta-OH metabolite samples were compared to naloxone, naltrexone and standard 6alpha-OH naltrexone (EN-2260A) using the jumping response of morphine pellet implanted mice. For the naloxone series, the potencies were: Naloxone greater than EN 2265A greater than 6 beta-OH maloxone. For the naltrexone series: Naltrexone greater than EN 2260A greater than beta-OH naltrexone. The low potency of the reduced metabolites the rapid onset of action of the parent compounds militate against the formation of these metabolites contributing substantially to the overall narcotic antagonist action of the parent compounds.

Animals↗
PubMed1977

Health status of a group of narcotic addicts in a methadone treatment programme.

This study, which arose out of a concern for the health status of narcotic addicts already in a treatment programme, has demonstrated that there is a severe level of impairment of general health. A summary of important findings is reported. Narcotic addiction leads to secondary medical morbidity and mortality, but health impairment also follows the gross disorder of living which has its roots in childhood, and early adolescent experience. Successful prevention and rehabilitation needs to be based on this knowledge.

Adult↗
PubMed1978

Hyper-alpha-2-macroglobulinemia in narcotic addicts.

Significant increases of serum alpha-2-macroglobulin (alpha-2-M) were detected in narcotic addicts presenting at a methadone treatment center. The mean alpha-2-M level was 341 +/- 14 mg/dl compared with 231 +/- 8 mg/dl in normal persons (p less than 0.01). In a comparable group of alcoholics with laboratory evidence of hepatic dysfunction the mean alpha-2-M level was 208 +/- 10 mg/dl. Although the serum immunoglobulin M content was also substantially elevated in the narcotic-addict group, no correlation was obtained between the serum content of this protein and alpha-2-M. Similarly, no correlation between alpha-2-M level and serum zinc content was observed. When the values of the trypsin-binding activity of serum measured in 13 addicts, 15 alcoholics with laboratory evidence of hepatic dysfunction, and 16 normal subjects were plotted against the amount of alpha-2-M measured in the same subjects, a linear correlation was obtained between trypsin-binding activity and alpha-2-M. Thus, the significantly increased serum trypsin-binding activity observed in the addicts is that which might be expected if normal alpha-2-M is being accumulated in large amounts as a result of increased macroglobulin synthesis.

Blood Proteins↗
PubMed1989

Portable narcotic infusion devices in Canada.

Several types of portable infusion devices are now available, allowing patients to receive continuous parenteral narcotics at home. Six of the most commonly used pumps in Canada are presented. Various features of the pumps are compared including cost, flow rate, bolus capability, ease of operation, medication preparation and safety. Consideration of all these factors should aid an institution in selecting a narcotic infusion device.

Canada↗
PubMed1999

[Characterization of drug, narcotic and psychotropic drug chirality by statistical methods].

The percentage of chiral entities among drug, narcotic drug and psychotropic compounds is steadily increasing. Receptors of the human body recognize the enantiomeric forms of constitutionally identical compounds as entirely different chemical agents. Based upon these facts, this paper reports the percentage of chiral compounds in the various pharmacological classes, and related data. Pertinent terms, such as eutomer, distomer, eudismic index, eudismic affinity quotient are defined. Differences in biological activity between eutomers and distomers are exemplified. The pharmacological classes and subclasses of highest chirality, and the "most chiral" active principles are shown. Some puzzling observations on pharmacological behaviour of stereoisomers are highlighted. The necessity of "racemate switch" in the pharmaceutical industry, and the significance of stereo-specific interactions between the drug, narcotic drug and psychotropic ligands, and complementary, "pocket" moieties of the human body are emphasized. Some features of enantiopharmacology, a fledgling science in the interface of stereochemistry and traditional pharmacology are introduced. The statistical treatment of asymmetric compounds in pharmacological classes and subclasses shows that presently, the percentage of chirality in drug categories is more characteristic of the origin of the compound than its target molecule.

Humans↗
PubMedDate not supplied

[The forensic chemical analysis of cadaveric material for the presence of drug and narcotic compounds].

The authors consider that the list of drugs and narcotics which can be reliably identified in a general forensic chemical analysis of cadaveric material (not a purposeful screening) should be changed. Isolation by acidified water, hydrochloric acid hydrolysis, and by acetonitrile should be used for isolation of drugs and narcotic compounds in forensic chemical analysis of cadaveric material.

Cadaver↗
PubMedDate not supplied

The poisons and narcotics of the Amazonian Indians.

The indigenous tribes of the Amazonian rainforest have discovered a vast array of poisons and narcotics from the plant species which surround them. Examples are given from the author's personal experience of a variety of arrow poisons, fish poisons and narcotics used by six different tribes. There is a great variety of different plant species used for each category and no two tribes studied employ exactly the same array of plant species. This makes it important to survey a wide range of tribes and to document this information before it is too late as these people are fast losing their traditional culture. Several of the substances used by Amazonian Indians, such as curare and coca, have entered into western medicine and others such as rotenone, an ingredient of their fish poison, has become a useful insecticide. Further useful chemicals are likely to be discovered from ethnobotanical work among indigenous peoples and it is vital that any commercial gain from their knowledge be of direct benefit to these people in accordance with the rules of the Convention on Biological Diversity.

Brazil↗