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| D-(+)-3-methoxy-17-methyl- (9α,13α,14α)-morphinan | |
| CAS number 125-71-3 | ATC code R05DA09 |
| Chemical formula | C18 H25 N O |
| Molecular weight | 271.4 |
| Bioavailability | ? |
| Metabolism | hepatic |
| Elimination half-life | ? |
| Excretion | ? |
| Pregnancy category | C ( United States) A ( Australia) |
| Legal status | Schedule 2 ( Australia) |
| Route of administration | Oral |
Indicated for:
RecreationalRecreational drug use is the use of psychoactive drugs for recreational rather than medical or spiritual purposes, although the distinction is not always clear. Regardless of medical supervision, this label does not apply to the use of drugs for utilitari uses: |
Dextromethorphan hydrobromide (DXM for short) is an antitussive drug that is found in many over-the-counter coldThe common cold is a mild viral infectious disease of the nose and throat, the upper respiratory system. Its symptoms are sneezing, sniffing, running/blocked nose (often these occur simultaneously, or one in each nostril), scratchy, sore, or phlegmy throa remedies and cough syrups. In considerably higher doses, DXM is a powerful dissociative psychedelic drug.
Dextromethorphan was first patented with U.S. Patent 2,676,177. In the 1960's, a tablet form of dextromethorphan was marketed in the United States and abroad as Romilar. As Romilar was marketed as an alternative to codeine, it was soon discovered that large doses of dextromethorphan had psychedelic effects by those who used codeine. For some time, many doctors denied that the drug was psychoactive; indeed, it for all intents and purposes is not in the recommended dose.
Dextromethorphan is the dextrorotary- enantiomer of the opioid-receptor agonist levomethorphan . Unlike most opioids, it has not been reported to possess significant analgesic properties or dependence-liability. It is, however, a potent antitussive and has largely replaced codeine in this indication. It is perhaps the most widely available and used antitussive currently marketed.
An active metabolite of dextromethorphan is dextrorphan , the 3-hydroxy derivative of dextromethorphan. The effects of dextromethorphan are believed to be caused by both dextromethorphan and dextrorphan. Dextromethorphan is predominantly metabolized by the liver, by the hepatic cytochrome P450 enzyme known as CYP2D6. There is a significant proportion of the population who have a functional deficiency in this enzyme (CYP2D6 poor metabolizers). As CYP2D6 is the primary metabolic pathway in the inactivation of dextromethorphan, the duration of action and effects of dextromethorphan are significantly increased in such poor metabolizers. Deaths and hospitalizations have been reported in poor metabolizer recreational users.
A large number of medications (including antidepressants) are potent inhibitors of CYP2D6 (see CYP2D6 article). There exists, therefore, the potential of drug-drug interactions between dextromethorphan and concomitant medications. There have been reports of fatal consequences arising from such interactions.
Dextromethorphan crosses the blood-brain barrier, and the following pharmacological actions have been reported:
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