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Opiates and you

Understanding how opiates work mitigates risk and enhances benefits ... Drug ampoule Retrieved May 04 2007 from http://commons.wikimedia.org/wiki/Image: ...

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Opiates and you

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    Slide 1:Opiates and you

    By Steven Malins

    Slide 2:Morphine and other opiates are used extensively in our society

    Slide 3:As biologists we must decide when and how to use them

    Slide 4:Though useful as painkillers, opiates have drastic negative effects

    Slide 5:Understanding how opiates work mitigates risk and enhances benefits

    Slide 6:We must examine the effect and action of opiates

    Slide 7:Doctors use opiates for a variety of reasons

    Slide 8:Opiates reduce pain from trauma

    Morphine and derivatives are used to treat pain such as long bone fractures, and other injuries with significant pain Side effects include nausea, dependence on the drug, and respiratory depression Despite side effects, opiates like morphine are some of the best painkillers available to medical professionals.

    Slide 9:Opiates can be used to treat chronic pain

    Along with acute pain from trauma, opiates are used to treat many disorders with chronic pain Doctors in the US and UK advise the use of morphine or other opiates for the treatment of vaso-occlusive crises associated with sickle cell disease Solomon, Lawrence (2006). Treatment of pain due to vaso-occlusive crises (VOC) in adults with sickle cell disease (SCD): Limited awareness of available guidelines. 48th Annual Meeting of the American-Society-of-Hematology

    Slide 10:Opiates may help treat cancer

    Opiates have a wide range of effects besides acting as analgesics They negatively regulate many cell processes, in several of the bodies tissues Opiates were found to decrease growth of Hepatocellular carcinoma and cause apoptosis in these tumor cells Notas, G et all (2007). The inhibitory effect of opioids on HepG2 cells is mediated via interaction with somatostatin receptors. European Journal of Pharmacology 555(1)

    Slide 11:Opiates cause widespread changes in the body

    Slide 12:Opiates act on G-Protein linked receptors

    Opiate drugs act on membrane receptors that are linked with protiens that use GTP These proteins are called G protien coupled receptors (GPCRs) It has been shown that these receptors have multiple active states, not just a single activated state These different states are believed to be caused by different opiates and may be the key to minimizing side effects Pineyro, G, Elodie Archer-Lahlou (2007). Ligand-specific receptor states: Implications for opiate receptor signalling and regulation. Cellular Signalling 19 (1)

    Slide 13:Opiates cause GI problems including constipation

    Among the other negative side effects of opiates is their depression of the Gastro Intestinal system causing constipation The enteric nervous system(ENS) is located in the digestive tract and it manages propulsion through the intestines Opiates act on opioid receptors and ophianin FQ/nocieptin receptors in the ENS inhibiting GI functionality. Bohn, L, Kirsten Raehal (2006). Opioid receptor signaling: relevance for gastrointestinal therapy. Current opinion in Pharmacology vol 6 (6)

    Slide 14:Opiates affect gene expression in the hippocampus

    Opiate addiction is often long term and recovering addicts report cravings long after use is discontinued. Studies in rats have shown that at least 20 genes show differential expression after exposure to morphine This data was gathered by a cDNA comparison of hippocampus’ of the rats Marie-Claire et al (2007). Sensitization to the conditioned rewarding effects of morphine modulates gene expression in rat hippocampus. Neuropharmacology 52(2)

    Slide 15:Discontinuing opiate use is difficult

    Slide 16:Opiates affect gene expresion

    Morphine causes gene expression changes in neuron cells and other cells in the body These genes affect cell growth and death, and cell morphology as well as neuron excitability Many of these changes, while relatively quick to take place once on morphine, take time to reverse Thus the body response with cravings for morphine long after its use is discontinued McClung, C.A. (2006). The molecular mechanisms of morphine addiction. Reviews in the Neurosciences 17 (4)

    Slide 17:Withdrawal symptoms are unpleasant

    Between 8 and 12 hours after taking heroin, or other opiates, individuals experience: Watery eyes, yawning, sweating Restlessness, insomnia, bone and joint pain Symptoms peak between one and two days after the last dose Though symptoms of withdrawal dissipate after about 10days, cravings and fatigue continue. Mattick, R.P., Wayne Hall. (1996) Are detoxification programmes effective? The Lancet 347 pp97-100

    Slide 18:Our brains associate related experiences with the “high” of morphine

    Opiates like morphine trigger the “reward” mechanism of our brain In the limbic system This is asociated with feelings of euphoria It has been shown in mice, which are a model organism for humans, that locations where morphine was administered triggered the reward response even when there was no drug being administered. German, P.W. and Howard L. Feilds (2006). Rat Nucleus Accumbens Neurons Persistently Encode Locations Associated With Morphine Reward. Journal of Neurophysiology 97

    Slide 19:We now have the tools and knowledge to understand opiate’s affects

    Slide 20:Only with continued research can we learn to use opiates more effectively

    Slide 21:Research must continue on medicines like morphine

    Slide 22:You will be the ones doing such research

    Slide 23:Image credits, in order of use

    J.J. (2005) Mad scientist caricature Retrieved May 04 2007 from http://commons.wikimedia.org/wiki/Image:Mad_scientist_caricature.png Theo (1999) The final solution med Retrieved May 04 2007 from http://commons.wikimedia.org/wiki/Image:The_final_solution_med.jpg Felix Plasser (2007) 3D structural formula of morphine Retrieved May 04 2007 from http://commons.wikimedia.org/wiki/Image:MorphinPyMOL.png Public domain, from US Department of Agriculture. Ignis (2005). Drug ampoule Retrieved May 04 2007 from http://commons.wikimedia.org/wiki/Image:Drug_ampoule_JPN.jpg Albrecht Durer (1471-1528). Anatomy and geometrical proportions Retrieved May 04 2007 from http://commons.wikimedia.org/wiki/Image:Anatomical_and_geometrical_proportions_-_Albrecht_Dürer.png Pollo Telescopic aerial platform unit Helsinki H16 Retrieved May 04 2007 from http://commons.wikimedia.org/wiki/Image:H16_training.jpg Microsoft clip art included with PowerPoint J Rawls (2005) What's behind me Retrieved May 04 2007 from http://commons.wikimedia.org/wiki/Image:Car_side_mirror_sunset.jpg

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