21 Feb Opioid Article Compares Agonists, Partial Agonists, and Antagonists
“Opioids” is a term used to group together a variety of painkiller medications, but they also include sub-categories of agonists, partial agonists, and antagonists. At Integrated Pain Consultants, all opioids are prescribed very conservatively and almost always for short-term pain situations (such as recovering from a broken bone). Recently, Dr. Jeffrey Fudin, PharmD, addressed exactly what the differences in these sub-categories are and what it means for patients. Since opioids are a highly addictive narcotic, it’s critical that both medical professionals and patients understand the side effects and risks.
Pharmacodynamics, or the study of what drugs do to the body, is Dr. Fudin’s specialty. The most common adverse side effects of opioids include constipation, sexual dysfunction, cognitive impairment, nausea, fatigue, and vomiting. Furthermore, opioids have four different types of receptors including mu, delta, kappa, and ORL-1. Each of these receptors can come with their own host of side effects ranging from depression to dysphoria. However, most are “mu” which happens to come with the most side effects-including dependence.
When it comes to their “agonist” category, opioids might be full agonist, partial agonist, mixed agonist, or antagonist. The full agonist list includes well-known prescriptions such as codeine, fentanyl, hydrocodone, hydromorphone, oxycodone, morphine, and even the illegal drug heroin. The remaining three types of agonists/antagonists are fewer and farther in between and lesser known. Most prescribed and street opioids are full agonists, which bind closely to the opioid receptors in order to offer the maximum effects. Due to how they work and attach to receptors, partial agonists might make someone take a higher dose, but the feel-good benefits remain the same while the side effects increase. Mixed agonists vary in how they work in the body, and of course, antagonists are used by medical professionals and emergency responders to bring someone back from an opioid overdose. Confused yet?
In other words, “opioids” is an overarching term to mean a lot of different drugs, categories of drugs, and how they work. Opioids can sometimes be an effective part of pain management, but only when prescribed by a reputable medical professional. If you’re interested in changing your pain management approach, perhaps with safe opioid inclusion, contact Integrated Pain Consultants today for your consultation. We also invite you to learn more about Dr. Nikesh Seth and other providers including Dr. Anne-Marie Cosijns, Dr. Lisa Sparks, Dr. Michael Givens, and our team of Nurse Practitioners.