Hydromorphone – Use And Side Effects
Hydromorphone is a semisynthetic morphine-derived painkiller that is 5 times more potent than opioids, but has a shorter effect.
This drug is due to its analgesic effect due to the interaction with the μ-opioid receptors, which are present in both the central nervous system and the smooth muscle.
The route of administration can be both enteral and parenteral. The binding to μ-receptors is the cause of both the analgesic effect and the side effects.
Opioid analgesics are one of the strongest pillars in the pharmacological field for the treatment of moderate to severe pain. Especially when it comes to acute pain and pain resulting from an oncological disease.
Clinical studies in the treatment of acute pain show that this medicine has an analgesic equivalent similar to other opioids.
It has been evaluated with respect to the treatment of cancer pain and other opioids with various formulations. Researchers observed that it is a morphine-equivalent drug in terms of its analgesic power and side effects.
There are still no controlled clinical trials that can provide scientific evidence for the efficacy of hydromorphone use in patients being treated for non-cancer chronic pain.
A little story about hydromorphone
As you can see, hydromorphone is a semisynthetic drug derived from morphine. Researchers synthesized it in Germany in 1921. The first results on its clinical efficacy were published in 1926. However, it was not until 1981 that they conducted various pharmacokinetic and pharmacodynamic studies on the properties of this molecule.
Pharmaceutical companies market this type of medication under different brands, presentations and doses. Immediate release preparations are not available in any country.
How does hydromorphone work in our bodies?
Hydromorphone is a potent agonist of the μ-opioid receptors. Like the other types of opioid receptors, these are linked to G proteins and act as modulators – both positive and negative. These are mainly due to the synaptic transmission that takes place through this protein.
Hydromorphone does not change the pain threshold of the nerve endings or affect the transmission of impulses along the peripheral nerves.
The analgesia produced is due to the changes it causes in the perception of pain in the spine by joining the mentioned receptors. This medicine, like other opiates, has a very high analgesic effect.
Side effects of hydromorphone
Hydromorphone, like all other medicines sold on the market, is not exempt from causing all kinds of side effects.
Among the most common side effects observed in patients treated with this medicine, we can mention the following:
- Nausea
- Vomiting
- Constipation
- Drowsiness
- Euphoria
- Dry mouth
- Dizziness
As for the serious side effects associated with this drug, they include respiratory depression and apnea, as well as circulatory collapse, shock, respiratory and cardiac arrest.
Conclusion
Although hydromorphone has analgesic and pharmacological properties and the side effects are similar to morphine, there is still controversy about the doses between these two drugs and between enteral and parenteral doses.
At present, there is not much published data on the quality of the role of hydromorphone in the treatment of chronic pain that originates in an oncological disease. Thus, more research should be conducted in this area, and clinical trials will continue to study the effects of hydromorphone in this type of patient.
