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This requires them to increase their drug dosage to maintain the benefit, and that in turn also increases the unwanted side effects. [72] Long-term opioid use can cause opioid-induced hyperalgesia, which is a condition in which the patient has increased sensitivity to pain. [95] All of the opioids can cause side effects. [64]
Codeine is used to treat mild to moderate pain. [4] It is commonly used to treat post-surgical dental pain. [13]Weak evidence indicates that it is useful in cancer pain, but it may have increased adverse effects, especially constipation, compared to other opioids. [14]
Most morphine produced for pharmaceutical use around the world is actually converted into codeine as the concentration of the latter in both raw opium and poppy straw is much lower than that of morphine; in most countries, the usage of codeine (both as end-product and precursor) is at least equal or greater than that of morphine on a weight basis.
Opioid switching, also called opioid rotation, is the replacement of the current opioid with another pharmacological agent such as morphine or methadone. It was effective in some studies, but can increase sensitivity to pain, requiring higher doses of the opioid-sparing drug. [33]
Despite morphine being the most medically significant opioid, larger quantities of codeine are consumed medically, most of it synthesized from morphine. Codeine has greater and more predictable oral bioavailability. Codeine is not reliably metabolised into its active form, morphine, by CYP2D6 due to the considerable amount of polymorphism. Many ...
If this is or becomes insufficient, a weak opioid is replaced by a strong opioid, such as morphine, diamorphine, fentanyl, buprenorphine, oxymorphone, oxycodone, or hydromorphone, while continuing the non-opioid therapy, escalating opioid dose until the patient is pain free or at the maximum possible relief without intolerable side effects.
These include morphine, codeine, oxycodone and hydrocodone, with brand names OxyContin, Vicodin and Lortab. Depressants that are used to treat anxiety and sleep disorders include brands like ...
Morphine, the archetypal opioid, and other opioids (e.g., codeine, oxycodone, hydrocodone, dihydromorphine, pethidine) all exert a similar influence on the cerebral opioid receptor system. Buprenorphine is a partial agonist of the μ-opioid receptor, and tramadol is a serotonin norepinephrine reuptake inhibitor (SNRI) with weak μ-opioid ...