Fentanyl
Fentanyl is mainly respired; once ingested, it is absorbed into the bloodstream, and the most primitive and sensitive part of the brain is sensitized. As a result, dopamine levels in the brain are increased, which gives a rewarding experience (Vice, 2016). The dopamine surge in the brain and its effects of increasing your activity levels make one always desire to use the drug often. The pharmacokinetic principle that best associated with the physical withdrawal symptoms is the distribution to the body. Fentanyl is mainly distributed to the brain, where it causes the increased release of dopamine. Once the pill is taken, one feels relaxed, functional, and energetic to carry out the day’s activities.
Naloxone
The mechanism of action of naloxone is that it reverses the effects of opioids once they are overdosed and causes respiratory distress. Naloxone belongs to the chemical class of opiate antagonists. The anatomical part of the brain turned off during an overdose is the medulla oblongata. The dosage of naloxone administered for the reversal of an overdose is not adequate for reversing the side effects of an opioid (Vice, 2016). Naloxone has a short half-life, and the duration of action of the drug is usually short-term compared to opioids. For an individual to reverse the effects of the drugs, it is recommended that more than one dose of the drug be administered to the person. The use of naloxone, though, is likely to cause withdrawal symptoms as it reverses the effects of the opioids that are administered.
Suboxone
Suboxone is a mixture of medications, and it contains buprenorphine and naloxone. Once it is ingested into the body, it binds tightly to the dopamine receptors that the opioids bind to in the brain; this reduces the binding of the opioids. (Vice, 2016). When it binds to these receptors, it reduces the effects of opioids by reducing the intoxication of these drugs to the user. It also reduces the desires and cravings they have to use the opioids, and to some extent, allows the addicts to avoid abusing the opioids and return to a drug-free state.
The preferred route for Suboxone administration is sublingual, and the drug is allowed to dissolve through this route to increase its efficiency. Overdosing Suboxone is not as easy as it may seem as it is impossible for one to overdose on Suboxone singly (Vice, 2016). Suboxone is a drug that binds partially to the opiate receptors and specifically dopamine; hence, it does not produce high effects brought about by opioids. Thus, the drug limits the number of effects brought about by opioids and rarely brought about the side effects like slow breathing rates. An overdose of the drug may only occur when the drug is administered alongside drugs that slow down breathing rates, such as sedatives.
Heparin
Heparin is an anticoagulant drug that is administered subcutaneously and acts by activating antithrombin. Antithrombin is an anticoagulation factor, and it also accelerates the rate at which antithrombin inhibits the clotting enzymes. Heparin is administered once daily, and the dosage administered is usually 1 gram (Thrombosis, 2021). Therefore, it is mainly administered before surgery, and at this point, warfarin administration is usually stopped as its anticoagulant effect is usually outside the desired therapeutic range.
Warfarin
Warfarin, on the other hand, is an anticoagulant that is administered orally. Warfarin acts by inhibiting the y-carboxylation step by inactivating the enzyme epoxide reductase, thus reducing the release of the vitamin K-dependent factors for clotting, inhibiting clotting of blood (Thrombosis, 2021). Therefore, when transitioning heparin to warfarin, heparin is given alongside warfarin for a minimum of 4 to 6 days until blood is sufficiently thinned. Afterward, heparin therapy is withdrawn, and warfarin is given alone. The rationale for stopping heparin therapy is that continued administration may lead to heparin-induced thrombocytopenia.
References
Vice. (2016). Fentanyl: The Drug deadlier than heroin. Web.
Thrombosis Canada. (2021). Clinical guides. Web.