Comment by Someone
2 days ago
> Fentanyl will kill you the first time you're exposed to it.
Its lethal dose is a lot smaller than that of heroin, but it isn’t guaranteed to kill. If it were, why is it used so much in medicine?
https://en.wikipedia.org/wiki/Fentanyl: “Fentanyl is a highly potent synthetic opioid of the piperidine family, used primarily as pain medication
[…]
In 2015, 1,600 kilograms (3,500 pounds) were used in healthcare globally.
It is on the World Health Organization's List of Essential Medicines.”
There's always a continuity there ("the dose makes the poison"), there's no known substance that will reliably kill you if you're exposed to a single molecule of it.
The issue with potency is that the more potent a substance, the more precise equipment and quality control you need to stay on the safe side. With fentanyl, healthcare and pharmaceutical industry can handle the precision and QC demands (which includes guarantees and maintaining public trust). Criminal enterprises cannot.
Carfentanil has got to be closer to that. It is said to be up to 100x more powerful than fentanyl.
Micrograms (yes still many molecules) could be lethal
1.53 × 10¹⁵ molecules per 1mcg. Which is 15 orders of magnitude larger than a single molecule. If 2mg of fentanyl is considered potentially lethal that would place carfentanyl at 20mcg, though I’ve heard conflicting reports on potency with some placing it at 10x not 100x. So roughly 16-17 orders of magnitudes.
I don’t take fentanyl but I regularly take signaling peptides where the doses are typically in the mcg range and still rather potent - though with signaling peptides the response curve typically flattens out so bigger doses don’t necessarily mean stronger effects - they can be saturated. Depends on what you’re signaling though.
I had correctly predicted my hypersensitivity to semaglutide (ozempic) so started using it for treating autoimmune issues at a dose of 25mcg and I still ended up with temporary gastroparesis.
prions perhaps?
Even with prions, there evidence that the body (and probably more so with some people than others) has some level of ability to resist, slow, or sometimes prevent a prion infection.
See these:
- The influence of PRNP polymorphisms on human prion disease susceptibility: an update [1]
- A naturally occurring variant of the human prion protein completely prevents prion disease | Nature [2]
[1] https://pubmed.ncbi.nlm.nih.gov/26022925/
[2] https://www.nature.com/articles/nature14510?utm_source=chatg...
is it used in general anesthesia?
for kids?
You are aware that "pharmaceutical" vs "poison" is a matter of doses and control, right?
That a dose not too different from adult posology of paracetamol can be lethal?
Maybe you did not know that "heroin" was developed at Bayer (the informal name came out of the trials after the reports from the testers)...
Pharmacology is the discipline that deals with drugs.
Mine was an honest question because I was concerned about my kid. She recently udnerwent a 30-min GA, even so, her behaviour has considerably changed. Her personality as well. So, I am not sure why it was being downvoted, and the snark in your comment is also undeserved.
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Yes, you require analgesics for general anesthesia, it’s not optional.
The reason synthetic opioids like fentanyl are used is because they actually have less side effects. Opioids can cause a histamine response, digestive issues and constipation. Newer synthetic and hybrid opioids cause that less, so they’re preferred in hospital settings.
There’s essentially no long term risk with the small doses required during surgery. The main risk is, of course, acute respiratory depression, which kills you. This is how opioid overdoses happen. This doesn’t happen under GA because the dose is tightly controlled, and your airway is supported anyway; you’re intubated.
Thank you very much for your kind response-- unlike the midwits who took issue with my question.
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I don't know about kids, but yes it is used in general anesthesia.
Thanks. That is alarming. I wonder what the long-term side effects would be even for one time, which my kid underwent. She is not the same anymore. She used to be so joyous.
yes. They used it for a heart surgery on a new born that I know.
Thanks. I asked because I didn't know, and my kid had undergone a surgery. The downvote was undeserved-- but maybe it also tells us something.