Clinical pharmacology of the narcotic analgesics

Opium has been used for the relief of pain at least as far back as records go. Morphine was separated from the mixture of opium alkaloids in 1806, and synthesis was accomplished in 1952. From an over-all viewpoint, morphine is still the most satisfactory narcotic analgesic, but certain untoward effects have fostered the search for a better compound, a goal still to be achieved. This review of the narcotic analgesics will deal with the clinical pharmacology of these substances with reference to morphine and meperidine, the best known substitutes, as yardsticks. A discussion of the general actions and uses of these drugs will be followed by a more detailed consideration of the commonly used compounds. It should be understood that few of the drugs have been studied satisfactorily in their entirety. This deficiency relates largely to the difficulty in determining drug effects on man under controlled conditions and to the haste in presenting new substances for clinical use before thorough study.