Buprenorphine

Class Opioid
Chemistry

Semisynthetic phenanthrene

Routes of administration

Oral, IV, topical

Absorption

Well absorbed orally, 15% bioavailability due to high first pass effect

Solubility

pKa 8..5, highly lipophilic

Distribution

VOD = 87-197L/kg; 96%  protein-bound

Metabolism

Hepatic metabolism; notable metabolites include norbuprenorphine, an active metabolite

Elimination

Minimal unchanged drug cleared renally, but most of the metabolites rely on renal excretion

Time course of action

Half-life 35 hours

Target receptor

mu-opiate receptor (pre-synaptic G-protein coupled receptor)

Mechanism of action

Hyperpolarisation of cell membrane by increasing potassium conductance; reduced production of cAMP and closure of voltage-gated calcium channels

Clinical effects

Analgesia, respiratory depression, constipation, miosis, urinary retention.

Literature reference

Crow et al (2021)

CICM details of understanding Level 2
Mentioned around Deranged Physiology
Related SAQs