Hydromorphone – Uses And Side Effects
Hydromorphone is a semi-synthetic morphine-derived analgesic that is 5 times more potent than opioids, but has a shorter duration of action. This drug owes its analgesic effect to its interaction with -opioid receptors, present in both the central nervous system and smooth muscle.
The route of administration may be either enteral or parenteral. The binding to μ receptors is the cause of both the analgesic effects and the side effects.
Opioid analgesics are one of the strongest pillars of the pharmacological range for the treatment of moderate pain. Especially when it comes to acute pain and pain due to an oncological disease.
Clinical studies in the treatment of acute pain show that this drug has analgesic equivalence comparable to that of other opioids.
There have been evaluations regarding the treatment of cancer pain and other opioids with different formulations. Researchers noted that it is a morphine equivalent drug in terms of its analgesic power and side effects.
Finally, we would like to mention that there are no controlled clinical studies that can provide scientific evidence about the effectiveness of the use of hydromorphone in patients being treated for chronic pain not related to cancer.
A little history about hydromorphone
As you have read, hydromorphone is a semi-synthetic drug derived from morphine. Scientists in Germany synthesized it in 1921.
The first results on clinical effectiveness were not published until 1926. However, it wasn’t until 1981 that they did several pharmacokinetic and pharmacodynamic studies on the properties of this molecule.
Pharmaceutical companies sell these types of drugs under different brands, presentations and dosages. However, immediate release preparations are not available in some countries.
How does hydromorphone work in our body?
Hydromorphone is a potent agonist of the -opioid receptors. And, like the other opioid receptors, these pair with the G proteins and act as modulators – both positive and negative. These are mainly the synaptic transfer that takes place via this protein.
Hydromorphone does not change the pain threshold of nerve endings, nor does it affect the transmission of impulses along the peripheral nerves.
The analgesia produced is due to the changes it causes in the perception of pain at the level of the spine when connecting the above receptors. This drug, like other opiates, has a very high analgesic potential.
Side Effects Of Hydromorphone
Hydromorphone, like all drugs 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 drug, we can mention the following:
- Nausea
- Vomit
- Constipation
- drowsiness
- Euphoria
- Dry mouth
- vertigo
As for the serious side effects associated with this drug, they include respiratory depression and apnea along with circulatory collapse, shock, and respiratory and cardiac arrest.
Conclusion
Thus, although hydromorphone has analgesic and pharmacological properties and its side effects are similar to those of morphine, there are still controversies about the doses between these two drugs and between enteral and parenteral doses.
Currently, there are also not many published data on the quality of the role of hydromorphone in the treatment of chronic pain arising from an oncological disease. So more research needs to be done in this area. Clinical studies will therefore continue to study the effects of hydromorphone in this type of patients.
