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

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