Opioids

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Classification

Classification by receptor affinity

• Opioid Agonists - Morphine, Codeine, Meperidine, Fentanyl, Sufentanil, Remifentanil, Methadone, Tramadol
• Opioid Agonist/Antagonists & Partial Agonists - Pentazocine, Nalbuphine, Butorphanol, Buprenorphine
• Opioid Antagonists - Nalorphine, Naloxone, Naltrexone, Naltrindole, Nalmefene

Classification by Exogenous Opioids Strength

According to the strength or potency based on the plasma concentrations at which they exert their effects. C₅₀ or the plasma concentration causing a 50% effect.

• Strong Opioids include fentanyl, sufentanil, and remifentanil
• Weak opioids include codeine and tramadol
• Intermediate group includes morphine, methadone, oxycodone, and buprenorphine

Classification by synthetic process

• Naturally occurring compounds - Morphine, Codeine, Thebaine, Papaverine
• Semi-synthetic compounds - Diamorphine (heroin), Dihydromorphone, Buprenorphine, Oxycodone
• Synthetic compounds - Pethidine, Fentanyl, Methadone, Alfentanil, Remifentanil, Tapentadol