Piritramid

Abstract

So far there is little evidence to support the widespread use of piritramide as first-line opioid analgesic for postoperative pain management in Germany. Especially lacking are in-depth studies about its mechanisms of action, receptor pharmacology, dose-response relationships and clinical dosing regimens. It is therefore questionable why piritramide is given priority.

Single hair analysis: Validation of a screening method for over 150 analytes and application on documented single‐dose cases

“…17 Applied to our case, piritramide seems to be incorporated mainly via the hair bulb and diphenhydramine preferably in the upper part of the root, although both substances have similar physicochemical properties (octanol water partition coefficient (log P) = 3.91 vs. 3.27; pka = 8.5 vs. 8.98, respectively). [27][28][29] In our opinion, the slightly higher lipophilicity of piritramide cannot solely explain the observed effect, and additional factors may influence drug incorporation. Due to similar chemical structures, Kuwayama et al 17 expected comparable results for the incorporation of methylephedrine and methoxyphenamine; however, differences indicate toward further mechanism being present.…”

Potentially Life-Threatening Interaction between Opioids and Intrathecal Baclofen in Individuals with a Childhood-Onset Neurological Disorder: A Case Series and Review of the Literature

“…38,39 In addition, the rate at which different opioids pass the BBB and are subsequently eliminated depends on their lipophilicity, with morphine passing and being eliminated slowly, while fentanyl and piritramide pass the BBB fast. 17,40 Depending on the specific opioid and the method of administration (e.g. bolus and continuous) concurrent with ITB, the duration of their simultaneous presence in the CNS varies, influencing the potential for mutual reinforcement.…”

Intravenous Opioid Medication with Piritramide Reduces the Risk of Pneumothorax During CT-Guided Percutaneous Core Biopsy of the Lung

“…Quite the contrary, especially the anxiolytic effect reduces patients´ discomfort and fosters patients´ cooperation. In many European countries, especially Germany, piritramide is the first-line opioid analgesic drug for the management of postoperative or posttraumatic pain [ 20 ]. Piritramide has been used for decades at our institution for periprocedural analgosedation with good experiences regarding effectiveness, safety and side effect profile.…”

“…Piritramide has been used for decades at our institution for periprocedural analgosedation with good experiences regarding effectiveness, safety and side effect profile. Yet the long onset time (17 min [ 20 ]) may delay the start of the biopsy. As piritramide is only approved in some European countries (e.g., Germany and Austria) but not for example in the United States of America [ 21 ], it would be interesting to investigate if the protective effect of piritramide could also be seen using similar opioid analgesics, for example fentanyl.…”