Sosegon

ソセゴン

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2020/09/17 03:20:06」(JST)

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Pentazocine

Clinical data
AHFS/Drugs.com	Monograph (hydrochloride) Monograph (lactate)
Pregnancy category	AU: C US: N (Not classified yet)
Routes of administration	Oral, IV, IM
ATC code	N02AD01 (WHO)
Legal status
Legal status	AU: S8 (Controlled drug) CA: Schedule I DE: Anlage III (Special prescription form required) US: Schedule IV
Pharmacokinetic data
Bioavailability	~20% orally
Metabolism	Hepatic
Onset of action	15 min
Elimination half-life	2 to 3 hours
Excretion	Renal
Identifiers
IUPAC name (2RS,6RS,11RS)-6,11-dimethyl-3-(3-methylbut-2-en-1-yl)-1,2,3,4,5,6-hexahydro-2,6-methano-3-benzazocin-8-ol or 2-dimethylallyl-5,9-dimethyl-2'-hydroxybenzomorphan
CAS Number	359-83-1 Y
PubChem CID	441278
IUPHAR/BPS	1606
DrugBank	DB00652 Y
ChemSpider	390041 Y
UNII	RP4A60D26L
KEGG	D00498 Y
ChEMBL	ChEMBL560 Y
CompTox Dashboard (EPA)	DTXSID7023433
ECHA InfoCard	100.006.032
Chemical and physical data
Formula	C19H27NO
Molar mass	285.431 g·mol−1
3D model (JSmol)	Interactive image
SMILES Oc1ccc3c(c1)[C@]2([C@H]([C@H](N(CC2)C\C=C(/C)C)C3)C)C
InChI InChI=1S/C19H27NO/c1-13(2)7-9-20-10-8-19(4)14(3)18(20)11-15-5-6-16(21)12-17(15)19/h5-7,12,14,18,21H,8-11H2,1-4H3/t14-,18+,19+/m0/s1 Y Key:VOKSWYLNZZRQPF-GDIGMMSISA-N Y
(verify)

Pentazocine, sold under the brand name Talwin among others, is a painkiller used to treat moderate to severe pain. It is believed to work by activating (agonizing) κ-opioid receptors (KOR) and blocking (antagonizing) μ-opioid receptors (MOR). As such it is called an opioid as it delivers its effects on pain by interacting with the opioid receptors. It shares many of the side effects of other opioids like constipation, nausea, itching, drowsiness and respiratory depression, but unlike most other opioids it fairly frequently causes hallucinations, nightmares and delusions. It is also, unlike most other opioids, subject to a ceiling effect, which is when at a certain dose (which differs from person-to-person) no more pain relief, or side effects, is obtained by increasing the dose any further.

Chemically it is classed as a benzomorphan and it comes in two enantiomers, which are molecules that are exact (non-superimposable) mirror images of one another.

It was patented in 1960 and approved for medical use in 1964. Usually, in its oral formulations, it is combined with naloxone so as to prevent people from crushing the tablets, dissolving them in a solvent (like water) and injecting them for a high (as orally administered naloxone produces no opioid-negating effects. Intravenous or intramuscular administration, however, does).

Use

Medical

Pentazocine is used primarily to treat pain, although its analgesic effects are subject to a ceiling effect. It has been discontinued by its corporate sponsor in Australia, although it may be available through the special access scheme.

Recreational

In the 1970s, recreational drug users discovered that combining pentazocine with tripelennamine (a first-generation ethylenediamine antihistamine most commonly dispensed under the brand names Pelamine and Pyribenzamine) produced a euphoric sensation. Since tripelennamine tablets are typically blue in color and brand-name Pentazocine is known as Talwin (hence "Ts"), the pentazocine/tripelennamine combination acquired the slang name Ts and blues. After health-care professionals and drug-enforcement officials became aware of this scenario, the mu-opioid-antagonist naloxone was added to oral preparations containing pentazocine to prevent perceived "misuse" via injection, and the reported incidence of its recreational use has declined precipitously since.

Research

In an open-label, add-on, single-day, acute-dose small clinical study, pentazocine was found to rapidly and substantially reduce symptoms of mania in individuals with bipolar disorder that were in the manic phase of the condition. It was postulated that the efficacy observed was due to κ-opioid receptor activation-mediated amelioration of hyperdopaminergia in the reward pathways. Minimal sedation and no side effects including psychotomimetic effects or worsening of psychosis were observed at the dose administered.

Adverse effects

Side effects are similar to those of morphine, but pentazocine, due to its action at the kappa opioid receptor is more likely to invoke psychotomimetic effects. High dose may cause high blood pressure or high heart rate. It may also increase cardiac work after myocardial infarction when given intravenously and hence this use should be avoided where possible. Respiratory depression is a common side effect, but is subject to a ceiling effect, such that at a certain dose the degree of respiratory depression will no longer increase with dose increases. Likewise rarely it has been associated with agranulocytosis, erythema multiforme and toxic epidermal necrolysis.

Tissue damage at injection sites

Severe injection site necrosis and sepsis has occurred (sometimes requiring amputation of limb) with multiple injection of pentazocine lactate. In addition, animal studies have demonstrated that Pentazocine is tolerated less well subcutaneously than intramuscularly.

History

Pentazocine was developed by the Sterling Drug Company, Sterling-Winthrop Research Institute, of Rensselaer, New York. The analgesic compound was first made at Sterling in 1958. U.S. testing was conducted between 1961 and 1967.It was approved by the Food and Drug Administration in June 1967 after being favorably reviewed following testing on 12,000 patients in the United States. By mid 1967 Pentazocine was already being sold in Mexico, England, and Argentina, under different trade names.

Society and culture

Legal status

Pentazocine was originally unclassified under the Controlled Substances Act. A petition was filed with the Drug Enforcement Administration on October 1, 1971, to shift it to Schedule III. The petition was filed by Joseph L. Fink III, a pharmacist and law student at Georgetown University Law Center as part of the course Lawyering in the Public Interest. That petition was accepted for review on November 10, 1971. D.E.A. published a Final Rule transferring it to schedule IV on January 10, 1979, with an effective date of February 9, 1979. This is understood to be the first instance of a successful petition to reclassify a substance under the relatively recently enacted Controlled Substances Act. Pentazocine is still classified in Schedule IV under the Controlled Substances Act in the United States, even with the addition of Naloxone. Some states classify it in Schedule II, such as Illinois and South Carolina (injectable form only), or Schedule III such as Kentucky.) Internationally, pentazocine is a Schedule III drug under the Convention on Psychotropic Substances. Pentazocine has a DEA ACSCN of 9720; being a Schedule IV substance, the DEA does not assign an annual manufacturing quota for pentazocine for the United States.

Brand names

Pentazocine is sold under several brand names, such as Fortral, Sosegon, Talwin NX (with naloxone), Talwin, Talwin PX, Fortwin and Talacen (with paracetamol (acetaminophen)).

See also

• Cyclazocine (hallucinogenic)
• Volazocine

External links

• Eurekalert report on PNAS article

English Journal

• PMID 31934231
• PMID 30000307
• PMID 3510458

Japanese Journal

• 気管支鏡検査における麻酔法の検討 : 診断的気管支鏡における麻酔についてのアンケート調査について

• 中岡 康,瀬在 幸安,大畑 正昭,飯田 守,大森 一光,伊良子 光正,北村 一雄,中村 士郎,小笠原 弘二,村松 高
• 気管支学 12(3), 254-261, 1990
• 診断的気管支鏡における麻酔法についてのアンケート調査の結果, 前投薬として硫酸アトロピンがほぼ全例に投与されており, 併用薬としては非麻薬性鎮痛鎮静剤が多用されている。しかし麻薬性鎮痛鎮静剤の方が鎮咳効果が勝っていた。麻酔法は106施設中105施設において2∿4%キシロカインを用いた局所麻酔が行われており, 1施設のみ原則として全身麻酔を行っていた。局所麻酔時の気管カニューレの挿管 …
• NAID 110002816576

• 慢性Pentazocine(Sosegon,Pentagin)中毒の3例

• 服部 英世,堀田 宣之,荒木 邦治
• 精神神経学雑誌 78(3), p235-241, 1976-03
• NAID 40002060336

• 子宮内容除去術におけるSosegon Horizon麻酔の使用経験

• 楠 義雄
• 産科と婦人科 42(5), p771-774, 1975-05
• NAID 40001457403

Related Links

• 医療用医薬品 : ソセゴン (ソセゴン注射液15mg) - KEGG

Sosegon Injection 15mg 丸石製薬 1149401A1027 61円／管 劇薬 , 向精神薬 , 習慣性医薬品 , 処方箋医薬品

• ソセゴン注射液15mg - Pmda

Sosegon Injection 15mg 薬価基準収載年月 1970年8月 販売開始年月 2012年10月 貯法・使用期限等 貯法 室温保存 使用期限 5年（ラベル等に表示の使用期限を参照すること） 規制区分 劇薬 向精神薬 習慣性医薬品 注意−習慣性あり

• Sosegon - Drugs.com

Sosegon is a medicine available in a number of countries worldwide. A list of US medications equivalent to Sosegon is available on the Drugs.com website.

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★リンクテーブル★

リンク元

「ペンタゾシン」

「ペンタゾシン」

　　[★]

英

pentazocine

ラ

pentazocinum

化

塩酸ペンタゾシン pentazocine hydrochloride

商

ソセゴン Sosegon(アステラス)、ペンタジン Pentagin(第一三共)、ペルタゾン、Talwin

関

全身麻酔薬、拮抗性麻酔薬

• 全身麻酔薬

• 拮抗性麻酔薬

作用機序

• μ受容体に対する部分作動薬、κ受容体の全てに対する作動薬であり、κ受容体を通じて麻酔作用を示す。

利点

• 胆道閉塞性疾患にも慎重に使用できる(ブプレノルフィンは慎重投与だがペンタゾシンの大量投与は慎重) μ2受容体がOddi筋収縮に関わるとされている。