Nalbuphine hydrochloride is a relatively new agonist-antagonist drug structurally related to the potent narcotic, oxymorphone (Numorphan®), and the potent narcotic antagonist, naloxone (Narcan®). (Figure 1.) Nalbuphine has a potency equivalent to morphine sulphate and meperidine (10 mg morphine sulphate and 75 mg meperidine being equivalent to 20 mg nalbuphine), 1 with an abuse potential which ...

Background: The stability of opioids and benzodiazepines was studied in patient urine samples stored at different temperatures over 30 days. Methods: Samples were prepared by solid phase extraction and quantified by liquid chromatography coupled to a tandem triple quadrupole mass spectrometer. Results: Sample storage conditions affected the stability of all drugs investigated. The concentration...

Background Being a disabling symptom of many medical conditions, effective pain control is one of the most important therapeutic priorities. Morphine and other opioid drugs produce analgesia primarily through μ opioid (MOP) receptors, which mediate beneficial but also the nonbeneficial actions. Appropriate identification of novel opioid analgesics may reduce complications and improve patient co...

An improved synthesis of a haptenic heroin surrogate 1 (6-AmHap) is reported. The intermediate needed for the preparation of 1 was described in the route in the synthesis of 2 (DiAmHap). A scalable procedure was developed to install the C-3 amido group. Using the Boc protectng group in 18 allowed preparation of 1 in an overall yield of 53% from 4 and eliminated the necessity of preparing the di...

Background Cancer pain is a significant clinical problem being one of the first symptoms of disease with 75–90% of the patients experiencing chronic pain syndromes in advanced stages [1]. The management of cancer pain is mainly based on the use of opioid drugs; however their clinical use is limited by high incidence of adverse effects. There is a continued search for highly efficacious opioid a...

Opana ER (oxymorphone) is an opioid drug available throughout the United States, and intravenous abuse of the crushed oral formulation has been associated with drug-induced thrombotic microangiopathy. In this abstract, we describe two young patients who lived together and used Opana ER intravenously. Both presented with microangiopathic hemolytic anemia that mimicked thrombotic thrombocytopenic...