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Acute use (1–3 days) yields a potency about 1.5× stronger than that of morphine and chronic use (7 days+) yields a potency about 2.5 to 5× that of morphine. Similarly, the effect of tramadol increases after consecutive dosing due to the accumulation of its active metabolite and an increase of the oral bioavailability in chronic use.
While 3-methylfentanyl is considerably more potent than fentanyl itself, lofentanil is only slightly stronger than carfentanil. [ 1 ] [ 2 ] This suggests that substitution at both the 3 and 4 positions of the piperidine ring introduces steric hindrance which prevents μ-opioid affinity from increasing much further.
The World Health Organization recommends using a two step treatment approach based on the level of pain in children. The first step explains mild pain treatment, while the second step considers moderate to severe pain. Opioids, such as morphine, is an example of a drug of choice for moderate-severe pain in children with medical illnesses. [36]
Meclizine is effective in inhibiting nausea, vomiting, and dizziness caused by motion sickness. [10] The drug is safe for treating nausea in pregnancy and is a first-line therapy for this use. [11] [12] Meclizine may not be strong enough for especially sickening motion stimuli, and second-line defenses should be tried in those cases. [13]
Fentanyl is a highly potent synthetic piperidine opioid primarily used as an analgesic (pain medication). It is 30 to 50 times more potent than heroin and 50 to 100 times more potent than morphine. [10] Its primary clinical utility is in pain management for cancer patients and those recovering from painful surgeries.
Such action extends the duration of enkephalin effect where the natural pain killers are released physiologically in response to specific potentially painful stimuli, in contrast with administration of narcotics, which floods the entire body and causes many undesirable adverse reactions, including addiction liability and constipation.
Approved indication for dihydrocodeine is the management of moderate to moderately severe pain as well as coughing and shortness of breath. As is the case with other drugs in this group, the antitussive dose tends to be less than the analgesic dose, and dihydrocodeine is a powerful cough suppressant like all other members of the immediate codeine family (see below) and their cousins ...
Meclizine is less anticholinergic than many other antihistamines and other agents used for their anti-emetic and anti-pruritic effects. [ citation needed ] Along with the aforementioned efficacy against nausea and itching, meclizine also shares the anxiolytic , analgesic-sparing (potentiating), sedative , and other effects of its chemical ...