The Opioid Class of Analgesics
	Legal Terms and Conditions
	Opioid Class of Analgesics: Slide 3
	Legal Terms and Conditions (cont’d.)
	Program Objectives
	Definitions
	Opioids
	Opioids & Receptor Activity
	Mu (µ) Receptor Activation
	Dose-response Curves
	How does this correlate to clinical pain management?
	Opioid Agonists: Structural Pharmacology
	Opioid Rotation (OR)
	Codeine
	Codeine
	Morphine
	Morphine
	M-3-G (morphine-3-glucuronide)
	M-6-G (morphine-6-glucuronide)
	M-6-G and M-3-G (continued)
	Renal Dysfunction and Morphine
	Hepatic Dysfunction and Morphine
	Pruritus and Morphine
	Oxycodone
	Oxycodone
	Oxycodone
	Hydrocodone
	Hydromorphone (HM)
	Biotransformation of HM
	Metabolite Profile of Hydromorphone
	Potential Role of HM Metabolites
	Methadone
	Methadone
	Methadone
	Propoxyphene
	Meperidine
	Normeperidine
	Fentanyl
	Levorphanol and Congeners
	Buprenorphine
	Agonist-antagonists
	Opioid Antagonists
	Summary

• Low Back Pain
• Evidence-based Pain Therapy
• Acute Postoperative Pain: Context, Outcomes and Clinical Interventions
• Session 8: Essentials
• Session 1: Essentials