Opioid Epidemic: Uses, Abuses, and Innovation: Hydrocodone - PowerPoint Presentation

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Opioid Epidemic: Uses, Abuses, and Innovation: Hydrocodone

Zoe Boomgarden and Danny PetersSlide2

Identity

Hydrocodone (dihydrocodeinone) is a semi-synthetic opioid

Often taken in conjunction with acetaminophen, ibuprofen, or aspirin

Examples of prescription drugs: Vicodin, Lorcet, Lortab, Hycet etc. Slide3

Structure

Hydrocodone

OxycodoneSlide4

Uses and Abuses

Commonly prescribed for moderate to severe pain although it is sometimes prescribed as a cough medicine

The effects of hydrocodone can last four to six hours depending on the specific medication

Due to the effects of hydrocodone (relaxation, calmness, pain relief, euphoria) abuse and addiction is often seen

In 2013, 46% of drug-related medical emergencies involved opioids.

“Hydrocodone Addiction and Abuse”

https://www.addictioncenter.com/opiates/hydrocodone/

(Accessed 5 Mar. 2018)Slide5

Synthesis with Thebaine

Carroll, R.J.; Leisch, H.; Rochon, L.; Hudlicky, T.; Cox, D.P.; “One-Pot Conversion of Thebaine to Hydrocodone and Synthesis of Neopinone Ketal”

; pp.747-52;

Journ. O. Chem. 2008Slide6

Analytical Data

Mass spectrum of hydrocodone

Mass spectrum of oxycodoneSlide7

Function and Dosage

Binds to mu receptors which keeps pain signals from being sent to the brain

Hydrocodone also sends signals of euphoria

Kosten, T.; George, T; “The Neurobiology of Opioid Dependence: Implications for Treatment”

National Center for Biotechnology Information.

2002

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Function and Dosage

The dosage amount and combination with other medication is mostly based on the doctor’s diagnosis and the patient’s tolerance to opioids

It has been recommended that hydrocodone not be prescribed in excess of 90 - 200 MME

Therefore, doses that may lead to addiction is highly subjective to each patient’s case

1 in 32 patients who died from an opioid-related overdose had increased their dosage to more than 200 MME

“How Much Hydrocodone Is Too Much in One Day?”

https://www.promises.com/articles/opiate-drugs/much-hydrocodone-much-one-day/

(Accessed 6 Mar

ch

2018)Slide9

Merits and Deficiencies

In 2013 there were more than 136 million prescriptions for products containing hydrocodone

A research study was able to develop a pure hydrocodone medication that had fast and long lasting effects.

Side effects include: sedation, respiratory depression, mental clouding, euphoria, agitation, constipation, diarrhea, abdominal bloating, nausea, vomiting, headaches, and dizziness

Krashin D; Murinova N; Trescot AM; “Extended-release hydrocodone - gift or curse?”

J Pain Res.

2013

; 6:53–57.Slide10

Merits and Deficiencies

“Hydrocodone And Ibuprofen (Oral Route) Description and Brand Names.”

Mayo Clinic

, Mayo Foundation for Medical Education and Research, 1 Mar. 2017, www.mayoclinic.org/drugs-supplements/hydrocodone-and-ibuprofen-oral-route/description/drg-20062862.Slide11

Merits and Deficiencies Compared with other Opioids

Hydrocodone is more orally available than codeine and is six times more active

1

It is equally as strong as morphine and 50% weaker than oxycodone 2

Can be combined with a decongestant or an expectorant so that it can be used as a nasal decongestant or cough suppressant 2

Oxycodone and hydrocodone are both used with acetaminophen to relieve pain and inflammation

1 LiverTox; “Hydrocodone”;

National Institute of Health;

https://livertox.nih.gov/Hydrocodone.htm

;(Accessed 06 March 2018);

2018

2 Office of Diversion Control; “Hydrocodone”;

Drug Enforcement Administration;

2014Slide12

Summary

Hydrocodone and Morphine are similar in pain relieving efficacy

It is most commonly mixed with acetaminophen

Although it is

extremely similar to oxycodone is terms of structure, it is 50% weaker than oxycodoneHydrocodone is an effective opioid used to treat moderate to severe pain although it may be abusedSlide13

QUESTIONS?