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Anticonvulsants and anxiolytics: Barbiturates
Anticonvulsants and anxiolytics: Benzodiazepines
Medications for neurodegenerative diseases
Opioid agonists, mixed agonist-antagonists and partial agonists
0 / 11 complete
0 / 3 complete
Opiates, naloxone, naltrexone
dextromethorphan overdose p. 707
heroin detoxification p. 596
for opioid toxicity p. 247, 569, 590
Opioid antagonists, like the name suggests, are medications used mainly to reverse the side effects of opioid agonists and to prevent opioid addicts from relapsing after they’ve recovered.
Now, all opioids work by binding to opioid receptors in the brain, spinal cord, and gastrointestinal tract.
Some are endogenous, meaning they are produced naturally by the body, like endorphin, short for endogenous morphine.
But others are exogenous, meaning they come from outside the body, like heroin and morphine, which come from the opium poppy; a flowering plant that oozes a milky white liquid.
To understand how opioids work, let’s zoom into a region of the brain tissue that has opioid receptors.
Normally, in the absence of endorphins, inhibitory neurons secrete a neurotransmitter called gamma-aminobutyric acid, or GABA, that prevents nearby neurons from releasing neurotransmitters like dopamine, serotonin, and norepinephrine.
Now, let’s say someone goes to play a rigorous game of badminton. Exercise releases endorphins which activate the three major opioid receptors located on the inhibitory neurons, called the mu, kappa, and delta receptors.
As endorphins bind to these receptors, they block the inhibitory neuron from releasing GABA, allowing the dopamine, serotonin, and norepinephrine secreting neurons to freely unload their neurotransmitters, which then gets picked up by another neuron in the same area.
Norepinephrine and serotonin release takes place in pain processing regions of the brain like the thalamus, brainstem, and spinal cord, resulting in a decreased sensitivity to pain.
Opioid antagonists are drugs that strongly bind to opioid receptors and prevent their activation. They are used to treat opioid overdose and addiction, and can also help to reverse respiratory depression and other adverse effects of opioids. Examples include drugs like naloxone, naltrexone, methylnaltrexone, and alvimopan.
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