Buy methadone online
Buy methadone online. Methadone is a synthetic, long-acting opioid with pharmacologic actions qualitatively similar to morphine and is active by oral and parenteral routes of administration. It is primarily a μ-receptor agonist and may mimic endogenous opioids, enkephalins, and endorphins and affect the release of other neurotransmitters—acetylcholine, norepinephrine, substance P, and dopamine. This accounts for its analgesic and antitussive properties, respiratory depression, sedation, decrease in bowel motility, increase in biliary tone, hormone regulation and increase of prolactin and growth hormone release, miotic pupils, nausea, and hypotension. Patients develop tolerance and physical dependence following repeated use. The tolerance may be only partial for most of the pharmacologic effects. An abstinence syndrome consisting of lacrimation, rhinorrhea, sneezing, gooseflesh, nausea, vomiting, fever, chills, tremor, and tachycardia occurs on abrupt discontinuation of the opiate or the administration of an antagonist such as naloxone hydrochloride. There is cross-tolerance and cross-dependence among the various opiates. This is the premise for using methadone in the detoxification and maintenance of heroin people addicted to heroin. Due to the long half-life and duration of action of methadone, the abstinence syndrome is delayed and prolonged but less severe than that from a shorter-acting opiate such as heroin.
Methadone is a good therapeutic alternative to morphine sulfate and other opiate analgesics in the treatment of severe, chronic pain. It is well absorbed orally, has analgesic effects comparable to other μ-opiate receptor analgesics like morphine, has a long half-life, and is not metabolized to any active metabolites that may pose a risk to the patient.
Morphine and methadone are both effective analgesic agents. In patients treated with opiates for chronic pain, the equivalent analgesic doses for morphine and methadone do not always follow a linear relation, so caution should be taken when switching a patient from morphine to methadone.
Parenteral methadone is about twice as potent as oral methadone. The normal adult dosage of methadone is 2.5 to 10 mg every 3 to 4 hours as needed for severe pain and 5 to 20 mg every 6 to 8 hours as needed for severe, chronic pain (for example, for patients who are terminally ill). The dosage and dosing interval of methadone for pain relief vary considerably. The dose should be adjusted to the individual needs of the patient.
Although methadone has a long half-life, analgesia is not related to the serum half-life, and frequent daily dosing intervals are usually required for pain relief. Caution should be taken not to increase the dose too high or too frequently when initiating therapy because toxic effects may ensue. Adjunctive analgesics should be considered during the first few days of the initiation of the methadone regimen.
Methadone is a good alternative for patients who are being given maximum doses of morphine. However, determining the proper methadone dose based on a patient’s current morphine requirement may be challenging. The relative equivalent analgesic dose of morphine to methadone has varied from 1:1 to 14:1 (14 mg of morphine to 1 mg of methadone).
Methadone crosses the placenta and can cause fetal dependence. Therefore, the administration of methadone during pregnancy should be limited to patients with an established opiate dependence. Opiate detoxification during pregnancy is not recommended because fetal distress has been documented during maternal withdrawal from opiates. Pregnant women who are dependent on opiates and their fetuses do better on a regimen of methadone rather than being untreated. The advantages of methadone maintenance treatment during pregnancy include longer gestational periods and higher birth weights than in mothers who are heroin users and are not treated, as well as a lower risk of fetal exposure to infectious diseases contracted through needle sharing.
Lower concentrations of methadone in the plasma and increased methadone clearances have been reported during pregnancy, likely due to increased metabolism. Higher doses may be required, especially in the third trimester. Dosage should be tailored to the individual during pregnancy to minimize the chance to relapse to heroin use and prevent withdrawal symptoms.
Neonates born to women who are dependent on methadone are at risk of developing an opiate abstinence syndrome, but the syndrome tends to develop more slowly, is more moderate in severity, and lasts longer than in infants born to heroin-dependent women.