Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1590/S0034-70942005000100015
Brazilian Journal of Anesthesiology
Special Article

Uma breve história do ópio e dos opióides

Opium and opioids: a brief history

Danilo Freire Duarte

http://dx.doi.org/10.1590/S0034-70942005000100015 Braz J Anesthesiol, vol.55, n1, p.135-146, 2005
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Resumo

JUSTIFICATIVA E OBJETIVOS: Desde tempos imemoriais, o ópio e os seus derivados, além de exercerem ponderável influência sobre o comportamento dos seres humanos, têm sido empregados como sedativo e como analgésico. A partir do século XIX, com o isolamento dos alcalóides do ópio e as facilidades para o emprego dessas substâncias por via parenteral, houve aumento do interesse pelo uso criterioso dos opióides na área médica e da análise das conseqüências sociais de seu uso abusivo. Justifica-se, pelo exposto, uma revisão histórica do ópio e dos seus derivados. CONTEÚDO: A evolução dos conhecimentos sobre o ópio, produto natural extraído do Papaver somniferum, e sobre os opióides, substâncias naturais, semi-sintéticas e sintéticas extraídas do ópio, bem como as principais referências a essas substâncias desde a Antigüidade foram avaliadas. Foi enfatizado o progresso obtido a partir dos trabalhos de Setürner que resultaram no isolamento da morfina. As investigações conduzidas por outros autores na busca de substâncias sintéticas que apresentassem vantagens sobre os produtos naturais foram mencionadas. A importância da descoberta dos receptores opióides e de seus ligantes endógenos foi sublinhada. CONCLUSÕES: No alvorecer do terceiro milênio, a despeito das pesquisas realizadas com drogas analgésicas de outros grupos farmacológicos, os opióides continuam sendo os analgésicos mais potentes, embora sua eficácia seja contestada em certos tipos de dor. Os atuais conhecimentos de Farmacologia Clínica permitem selecionar o opióide a ser administrado, considerando a doença e as condições do paciente, na busca da melhor relação custo-benefício.

Palavras-chave

ANALGÉSICOS, ANESTESIOLOGIA

Abstract

BACKGROUND AND OBJECTIVES: In addition to their major influence on human behavior, opium and opioids have been used for a long time as sedative and analgesic drugs. As from the 19th century, with the isolation of opium alkaloids and easy parenteral administration of these substances, there has been increased interest in the judicious medical use of opioids and in the analysis of social consequences of their abuse, which has justified a historical review of opium and opioids. CONTENTS: Further understanding of opium, natural product extracted from Papaver somniferum, and of opioids, natural opium-extracted semi-synthetic and synthetic substances, as well as major references to these substances since ancient times are evaluated. Breakthroughs after Setürner's studies, which have resulted in morphine isolation, are emphasized. Reference is made to other authors' investigations in the search for synthetic substances with advantages over natural products. The importance the discovery of opioid receptors and their endogenous binders is highlighted. CONCLUSIONS: In the dawning of the third millennium, regardless of studies with analgesic drugs of different pharmacological groups, opioids are still the most potent analgesics, although their efficacy has been questioned for some types of pain. Current Clinical Pharmacology knowledge allows for the selection of the opioid based on patient's disease and conditions, in the search for the best cost-benefit ratio.

Keywords

ANALGESICS, ANESTHESIOLOGY

References

Gozzani JL. Opióides e antagonistas. Rev Bras Anestesiol. 1994;44:65-73.

Corbett CE. Hipnoanalgésicos, em: Charles E Corbett, Elementos de Farmacodinâmica. 1966:217-234.

Martin WR. Pharmacology of opioids. Pharmacol Ver. 1983;35:283-303.

Booth M. Opium: a History. 1998.

Cohen MM. The history of opium and opiates. Tex Med. 1969;65:76-85.

Baraka A. Historical aspects of opium. Middle East J Anesthesiol. 2000;15:423-436.

Kritikos PG. The history of opium in antiquity. J Am Pharm Assoc. 1968;8:446-447.

Kritikos PG, Papadaki SP. The history of poppy and opium and their expansion in antiquity in the Eastern Mediterranean Area. Bull. Narcotics. 1967;19:5-10.

Macht DI. The history of opium and some of its preparation and alkaloids. JAMA. 1915;64:477-461.

Prioreschi P, Heaney RP, Brehm F. A quantitative assessment of ancient therapeutics: poppy and pain in Hippocratic Corpus. Med Hypothese. 1998;51:325-331.

Bíblia Sagrada. 1953.

Buckland AR, Williams L. Dicionário Bíblico Universal. 1929:261.

Wright DA. The history of opium. Med Biol Illus. 1968;18:62-70.

Tallmadge CK. Some anesthetics of antiquity. J Hist Med Allied Sci. 1946;1:515-520.

Al-Mazroa AA, Abdel Halim RE. Anesthesia 1000 years ago, Royal Society of Medicine International Congress and Symposium Series. 1989;134:46-47.

Amaral JLG. Anestesiologia: a evolução de uma especialidade. Compacta. 1995;1:3-15.

Sigerist HE. Laudanum in the Works of Paracelsus. Bull Hist Med. 1941;9:530-544.

Hamilton GR, Baskett TF. In the arms of Morpheus the development of morphine for postoperative pain relief. Can J Anaesth. 2000;47:367-374.

Haller Jr JS. Opium usage in nineteenth century therapeutics. Bull N Y Acad Med. 1989;65:591-607.

Gutstein HB, Akil H. Opioid Analgesics, em: Hardman JG, Limbird LL - Goodman and Gilman's Pharmacological Basis of Therapeutics. 2001:569-619.

Rocha e Silva M. Fundamentos da Farmacologia e suas Aplicações em Terapêutica. 1969;2:95-115.

Howard-Jones N. A critical study and the origins and early development of hypodermic medication. J Hist Med Allied Sci. 1947;2:201-249.

Basile AC, Sertie JAA, DeLucia R. Farmacodependência, em: DLucia R, Valle LBS, Oliveira Filho RM et al - Farmacologia Integrada, SP. 1991;2:157-170.

Seevers MH. Medical perspectives on habituation and addiction. JAMA. 1962;181:92-98.

Murphree HB. Analgésicos Narcóticos: Analgésicos Sintéticos, em: DiPalma JR, Drill-Farmacologia Médica. 1969:291-299.

Janssen PA. Potent new analgesics tailor-made for different purposes. Acta Anaesthesiol Scand. 1982;26:262-268.

Nora FS, Fortis EAF. Remifentanil: porque precisamos de outros opióides. Rev Bras Anestesiol. 2001;51:146-159.

Inturrisi CE. Clinical pharmacology of opioids for pain. Clin J Pain. 2002;18:(Suppl4):S3-S13.

Simon EJ, Hiller JM, Edelman I. Stereospecific binding of the potent narcotic analgesic (3H)Etorphine to rat-brain homogenate. Proc Natl Acad Sci USA. 1973;70:1947-1949.

Goldstein A, Lowney LI, Pal BK. Steriospecific and nonspecific interactions of the morphine congener levorphanol in subcellular fractions of mouse brain. Proc Natl Acad Sci USA. 1971;68:1742-1747.

Finck AD. Opioid receptor and endorphins: significance for Anesthesiology. Refresher Courses in Anesthesiology. 1979;7:103-114.

Eckenhoff JE, Elder JD, King BD. The effect of N-allyl normorphine in treatment of opiate overdose. Am J Med Sci. 1951;222:115.

Eckenhoff JE, Hoffman GL, Dripps RD. N-allylmorphine: an antagonist to the opiates. Anesthesiology. 1952;13:242-251.

Foldes FF, Lunn JN, Moore J. N-Allylnoroxy-morphone: a new potent narcotic antagonist. Am J Med Sci. 1963;245:23-30.

Muller A, Koch B, René F et al. Mécanismes de la tolérance et de la dépendance aux opiodes. Ann Fr Anesth Réanim. 1999;18:866-895.

Hughes J. Isolation of an endogenous compound from the brain with pharmacological properties similar to morphine. Brain Res. 1975;88:395-308.

Yaksh TL, Rudy TA. Analgesia mediated by a direct spinal action of narcotics. Science. 1976;192:1357-1358.

Bromage PR. Intraspinal narcotics: state of the art. Refresher Courses in Anesthesiology. 1982;10:27-36.

Wang JK, Nauss LA, Thomas JE. Pain relief by intrathecally applied morphine in man. Anesthesiology. 1979;50:149-151.

Behar M, Magora F, Olshwang D et al. Epidural morphine in treatment of pain. Lancet. 1979;1:527-529.

Nociti JR. Opiáceos: benefícios e riscos na Anestesiologia, na dor e nos cuidados intensivos. Rev Bras Anestesiol. 1993;43:277-282.

Lopes MB, Sousa LR, Porsani DF. Associação bupivacaína e morfina intra-articular para analgesia pós-operatória em cirurgia artroscópica de joelho. Rev Bras Anestesiol. 1999;49:165-168.

Stein C, Gramsch C, Herz A. Intrinsic mechanism of antinociception in inflammation: local opioid receptors and beta-endorphin. J Neurosci. 1990;10:1292-1298.

Mc Quay HJ. Opioid use in chronic pain. Acta Anaesthesiol Scand. 1977;17:175-183.

Holdcroft A, Power I. Recent developments: management of pain. BMJ. 2003;326:635-637.

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