{"title":"Levorphanol: revisiting an underutilized analgesic.","authors":"Eric Prommer","doi":"10.4137/PCRT.S13489","DOIUrl":null,"url":null,"abstract":"<p><p>Levorphanol (levo-3-hydroxy-N-methylmorphinan) is a step 3 opioid first developed in the 1940s as an alternative to morphine. Levorphanol belongs to the morphinan opioid series. Levorphanol has greater potency than morphine and is a potent N-methyl-d aspartate (NMDA) antagonist. Levorphanol interferes with the uptake of norepinephrine and serotonin, which makes it potentially useful for neuropathic pain. Glucuronidation changes Levorphanol to Levorphanol-3-glucuronide with excretion by the kidney. Levorphanol has a long half-life and may accumulate with repeated dosing. Levorphanol can be administered orally, intravenously, and subcutaneously. This article provides an update regarding the pharmacodynamics, pharmacology, and clinical efficacy of this often overlooked step 3 opioid. </p>","PeriodicalId":56348,"journal":{"name":"Palliative Care","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2014-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/PCRT.S13489","citationCount":"14","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Palliative Care","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4137/PCRT.S13489","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2014/1/1 0:00:00","PubModel":"eCollection","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 14
Abstract
Levorphanol (levo-3-hydroxy-N-methylmorphinan) is a step 3 opioid first developed in the 1940s as an alternative to morphine. Levorphanol belongs to the morphinan opioid series. Levorphanol has greater potency than morphine and is a potent N-methyl-d aspartate (NMDA) antagonist. Levorphanol interferes with the uptake of norepinephrine and serotonin, which makes it potentially useful for neuropathic pain. Glucuronidation changes Levorphanol to Levorphanol-3-glucuronide with excretion by the kidney. Levorphanol has a long half-life and may accumulate with repeated dosing. Levorphanol can be administered orally, intravenously, and subcutaneously. This article provides an update regarding the pharmacodynamics, pharmacology, and clinical efficacy of this often overlooked step 3 opioid.
左旋吗啡酚(左旋-3-羟基- n -甲基吗啡inan)是一种三级阿片类药物，最初是在20世纪40年代作为吗啡的替代品而开发的。左旋orphanol属于吗啡类阿片系列。左旋孤儿酚的效力比吗啡强，是一种有效的n -甲基-d天冬氨酸(NMDA)拮抗剂。左旋啡诺干扰去甲肾上腺素和血清素的吸收，这使得它对神经性疼痛有潜在的作用。葡萄糖醛酸化将左旋孤儿酚转化为左旋孤儿酚-3-葡萄糖醛酸盐，并经肾脏排泄。左旋orphanol的半衰期很长，重复给药可能会积累。左旋orphanol可口服、静脉注射和皮下注射。这篇文章提供了关于药效学，药理学和临床疗效的更新，这往往被忽视的第三步阿片类药物。
期刊介绍：
Palliative Care and Social Practice is an international, peer-reviewed, open access journal that publishes articles on all aspects of palliative care. It welcomes articles from symptom science, clinical practice, and health services research. However, its aim is also to publish cutting-edge research from the realm of social practice - from public health theory and practice, social medicine, and social work, to social sciences related to dying and its care, as well as policy, criticism, and cultural studies. We encourage reports from work with under-represented groups, community development, and studies of civic engagement in end of life issues. Furthermore, we encourage scholarly articles that challenge current thinking about dying, its current care models and practices, and current understandings of grief and bereavement. We want to showcase the next generation of palliative care innovation research and practice - in clinics and in the wider society. Relaunched in July 2019. Partnered with Public Health Palliative Care International (PHPCI) (Title 2008-2018: - Palliative Care: Research and Treatment)
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