natural alkaloids : occur naturally in opium
DESCRIPTION
Narcotic Analgesics. Natural Alkaloids : occur naturally in Opium . Synthetics : chemically produced narcotic analgesics with no relation to opium but produce similar effects. Three Characteristics. Relieve pain Produce withdrawal signs in dependant users when drug use stops - PowerPoint PPT PresentationTRANSCRIPT
![Page 1: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/1.jpg)
Natural Alkaloids: occur naturally in Opium.
Synthetics: chemically produced narcotic analgesics with no relation to opium but produce similar effects.
![Page 2: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/2.jpg)
Three Characteristics
1. Relieve pain
2. Produce withdrawal signs in dependant users when drug use stops
3. Will suppress withdrawal signs of chronic morphine administration
![Page 3: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/3.jpg)
Hydrocodone (Vicodin)
Codeine
Morphine
![Page 4: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/4.jpg)
Percodan Percocet
![Page 5: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/5.jpg)
OxyContin
![Page 6: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/6.jpg)
Demerol
![Page 7: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/7.jpg)
Opium
Natural Narcotic Analgesics
![Page 8: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/8.jpg)
Opium Processing
Ready for shipment
![Page 9: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/9.jpg)
Various Colors of Heroin
![Page 10: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/10.jpg)
Heroin ready for insufflation
![Page 11: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/11.jpg)
Heroin Baggies
![Page 12: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/12.jpg)
Powder to Injection
![Page 13: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/13.jpg)
Powder to Injection
Track Marks
![Page 14: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/14.jpg)
Needle Abuse
![Page 15: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/15.jpg)
Heroin Girl
![Page 16: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/16.jpg)
Heroin Street SlangSmack
Thunder
Hell dust
Big H
Nose drops
Down
H 800 bags of heroin
![Page 17: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/17.jpg)
Methadone
![Page 18: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/18.jpg)
Methadone
![Page 19: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/19.jpg)
Developed in Germany during WWII
First marketed in the us in 1947
Prescriptions for methadone have increased by nearly 700% from 1998 thru 2006.
Methadone
![Page 20: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/20.jpg)
http://www.deadiversion.usdoj.gov/drugs_concern/methadone/methadone_presentation0407_revised.pdf
![Page 21: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/21.jpg)
http://www.deadiversion.usdoj.gov/drugs_concern/methadone/methadone_presentation0407_revised.pdf
![Page 22: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/22.jpg)
http://www.deadiversion.usdoj.gov/drugs_concern/methadone/methadone_presentation0407_revised.pdf
![Page 23: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/23.jpg)
![Page 24: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/24.jpg)
![Page 25: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/25.jpg)
![Page 26: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/26.jpg)
![Page 27: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/27.jpg)
Methadone Maintenance Therapy “MMT”
The patient remains physically dependant on an opioid but is freed from the uncontrolled, compulsive & disruptive behavior. - Improved subjects health
- Decreased criminal activity
- Increased employment
![Page 28: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/28.jpg)
Effects are similar to morphine although they develop more slowly and last longer
Withdrawal symptoms are slower and milder
Advantages:Cannot be injected
Longer duration than Heroin
Methadone
![Page 29: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/29.jpg)
Relieves moderate to severe pain
Suppress coughing
Methadone Uses
![Page 30: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/30.jpg)
Maintenance
Daily dose of Methadone allows the Heroin addict to function normally with no physical need for up to 24 hours
![Page 31: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/31.jpg)
Typical Clinic
![Page 32: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/32.jpg)
Typical Clinic
![Page 33: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/33.jpg)
Current Methadone Use
DAWN – Drug Abuse Warning Network
Emergency Department Visits, 2005
![Page 34: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/34.jpg)
Tolerance
The same dose of the drug will produce diminishing
effects.
Steadily larger dose is needed to produce the same
effects
![Page 35: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/35.jpg)
If using a “normal” dose he/she may exhibit little or no evidence of psychophysical impairment.
Even tolerant users, when impaired, usually exhibit clinical evidence (vitals & eyes)
Impairment is more evident with new users or tolerant users who exceed “normal” dose.
Tolerance
![Page 36: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/36.jpg)
DependenceNeurons adapt to the repeated drug
exposure
Only function normally in the presence of the drug
When the drug is withdrawn, several physiological reactions occur
![Page 37: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/37.jpg)
Psychophysical Indicators
Divided attention
impairment
Poor coordination and balance
![Page 38: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/38.jpg)
No nystagmus.
Pupils will be constricted.
Eyelids will be droopy.
Eye Indicators
Ptosis
Miosis
![Page 39: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/39.jpg)
General Indicators
Track marks“On the nod”Slowed reflexesLow, slow, raspy speechFacial itchingDry mouthEuphoriaFlaccid muscle toneInability to concentrate
![Page 40: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/40.jpg)
1. Relief from the symptoms of withdrawal
2. Euphoria3. Relief from pain
Psychological Effects
![Page 41: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/41.jpg)
ChillsAches of the muscle or jointsNauseaSweatingGoose bumpsYawningTearing of the eyesRunny noseVomiting
Signs and Symptoms of Withdrawal
Begin 8-12 hours
Intensify for 14-24 hours
Insomnia at 24-36 hours
Peak 2-3 days
5-10 days clear
![Page 42: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/42.jpg)
Acute Action Vs WithdrawalAnalgesiaResp depressionEuphoriaRelaxation & SleepTranquilizationDecreased BPConstipationMiosisHypothermiaDrying of secretionsReduced sex driveFlushed warm skin
Pain & irritabilityPanting & yawningDysphoria & depressionRestlessness & InsomniaFearfulness & HostilityIncreased BPDiarrheaMydriasisHyperthermiaTearing & runny noseSpontaneous ejaculationChilliness & “gooseflesh”
Psychopharmacology by Meyer & Quenzer
![Page 43: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/43.jpg)
Drug Cravings
When someone has a relapse, the primary cause is psychological, but physiological mechanisms play an important part in this process.
After months or years of being drug-free, an individual may crave a drug because of the pleasant physiological effects that occur while using the substance.
plpnemweb.ucdavis.edu
![Page 44: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/44.jpg)
Drug CravingsThis supports the idea that psychological
factors may play a role in physiological factors.
Drug addiction causes long-term changes in the brain.
Psychologically, many individuals have relapses because they want to forget about their current situation, while physically the corticotropin-releasing hormone can trigger a drug craving when the individual feels stressed (Carlson, 2004).
![Page 45: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/45.jpg)
Classic Evaluation Results
Slow internal clock – drowsy
Slow deliberate movement on SFSTs
BP, pulse & temp will be down
Miosis <3.0mm
Reaction to light will be little to none
If the drug is wearing off HIPPUS may be evident
![Page 46: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/46.jpg)
Duration Of Effects
Drug Onset Duration
Heroin
Methadone
Dilaudid
Percodan
5-30 Minutes
5-30 Minutes
15 Minutes
15 Minutes
4-6 Hours
Up to 24 Hours
5 Hours
4-6 Hours
![Page 47: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/47.jpg)
Downside
“Downside Effect: An effect that may occur when the body reacts to the presence of a drug by producing hormones or neurotransmitters to counteract the effects of the drug consumed.”
![Page 49: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/49.jpg)
Other conditions that may cause similar symptoms
Extreme fatigue
Head injury
Hypotension
Severe depression
Diabetic reaction
![Page 50: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/50.jpg)
Overdose Signs and Symptoms
NARCAN
Slow and shallow breathingClammy skinBlue lipsPale or blue bodyExtremely constricted pupils
![Page 51: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/51.jpg)
![Page 52: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/52.jpg)
FINDINGS OF THE REASSESSMENT
Participants at the 2007 Reassessment of Methadone-Associated Mortality reported six overall findings:
![Page 53: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/53.jpg)
FINDINGS OF THE REASSESSMENT
1. Methadone-associated deaths continue to rise as supported by medical examiner, toxicology, and other data sources.
2. Males 35 and older had the highest rate of methadone-associated deaths, approximately twice that of females.
Substance Abuse and Mental Health Services Administration
![Page 54: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/54.jpg)
FINDINGS OF THE REASSESSMENT
3. The reason for the majority of methadone-associated deaths is often unknown, but if known, is largely the result of accidental exposures.
4. All forms of methadone distribution continue to rise, with the greatest increases in distribution for the tablet form and going to pharmacies.
Substance Abuse and Mental Health Services Administration
![Page 55: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/55.jpg)
FINDINGS OF THE REASSESSMENT
5. Prescriptions for methadone have risen, although they are far lower than for other opioids.
6. Circumstances of methadone-associated deaths vary by State, suggesting a complex phenomenon.
Substance Abuse and Mental Health Services Administration
![Page 56: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/56.jpg)
Three primary scenarios were seen in methadone associated deaths:
1)Accumulation to toxic levels of methadone during the start of opioid treatment or pain management due to overestimation of tolerance and methadone’s long, often variable, half- life .
2) Misuse of diverted methadone by individuals with little or no opioid tolerance.
3) Synergistic effects of methadone in combination with other CNS depressants (i. e., alcohol, benzodiazepines or other opioids).
![Page 57: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/57.jpg)
NH 2 2 12 33 37 29 51 25.5 3.9
Maine 6 20 13 43 36 55 61 10.2 4.6
Maryland 7 18 20 24 40 96 145 20.7 2.6
Mass 10 8 23 24 36 58 93 9.3 1.4
UnitedStates
1999 2000 2001 2002 2003 2004 2005Ratio2005:1999
total 786 988 1,456 2,360 2,974 3,849 4,462 5.7 1.5
Methadone deaths by stateMethadone deaths
per 100,000 population 2005
![Page 58: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/58.jpg)
Trends in methadone deaths and death rates
• From 1999 to 2005, poisoning deaths increased 66 percent from 19,741 to 32,691 deaths
• Whereas the number of poisoning deaths mentioning methadone increased 468 percent to 4,462
![Page 59: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/59.jpg)
• Since 1999, between 73 and 80 percent of poisoning deaths mentioning methadone have been classified as unintentional (3,701 such deaths in 2005),
• An additional 11 to 13 percent being of undetermined intent
• 5 to 7 percent as suicides,
• Less than 1 percent as homicides
Trends in methadone deaths and death rates
![Page 60: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/60.jpg)
Age
• Age-specific rates for methadone death are higher for persons age 35-44 and 45-54 years than for those younger or older
• for those in each of the 10-year age groups covering the span 25-54 years, the rates in 2004 were four to six times the rates in 1999.
![Page 61: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/61.jpg)
• The largest increase was for young persons 15-24 years; the rate in 2005 was 11 times that in 1999.
• The rate for those 15-24 years, however, was unchanged from 2004 to 2005.
Age
![Page 62: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/62.jpg)
Half-life
• The half-life of a drug is the name given to the time it takes for blood levels of a drug to drop to 50% of the peak concentration.
• The half-life of methadone depends upon whether it is a first dose or a dose given as part of an ongoing program.
![Page 63: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/63.jpg)
Single, first dose
The apparent half-life of a single oral dose of methadone is shorter than that in extended use.
This is because much of the initial dose becomes distributed into the tissue reservoirs and is therefore not available in the blood stream.
![Page 64: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/64.jpg)
Single, first dose
Following ingestion of oral methadone blood levels rise for about 4 hours and then begin to fall.
The apparent half-life of a single first
dose is 12-18 hours with a mean average of 15 hours.
![Page 65: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/65.jpg)
Half life of Methadone
![Page 66: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/66.jpg)
1. Relief from the symptoms of withdrawal
2. Euphoria3. Relief from pain
Psychological Effects
Why do they take Why do they take narcotic analgesics? narcotic analgesics?
![Page 67: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/67.jpg)
Half life of OpiodsGeneric Brand Half-life
Buprenorphine Buprenex® 2.2
Codeine Tylenol® III 3
Diacetylmorphine Heroin 2
Dihydrocodeine Synalgos®-DC 3
Fentanyl Duragesic® 2
Hydrocodone Vidodin® 4
Hydromorphone Dilaudid® 3
Levorphanol Levo-Dromoran® 12
Meperidine Demerol® 1.5
Methadone Dolophine® 24
Morphine MS Contin® 2
Oxycodone Percocet® 3
Oxymorphone Numorphan® 1.5
Propoxyphene Darvon® 9
http://www.heroinhelper.com
![Page 68: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/68.jpg)
OverdoseMethadone users expect the euphoria of other analgesics.
When they don’t get the euphoria they dose again or do another analgesic.
The Methadone level builds (consider the half life)
Subject’s breathing slows to a point of death
![Page 69: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/69.jpg)
Defense Tactics
During preliminary exam we ask “Are you sick or injured?”
“Is you pain under control?
“How long have you been on your current dose?”
“Is the dose increasing or decreasing?”
It is the pain, not the Methadone, It is the pain, not the Methadone, that causes the impairment.that causes the impairment.
![Page 70: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/70.jpg)
BuprenorphineA partial opiate agonist:
it blocks withdrawal and craving without producing a strong narcotic high.
Compound that binds to
receptors to cause a change in body function
![Page 71: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/71.jpg)
BuprenorphineNaltrexone is an opiate
antagonist that causes unpleasant side-effects for opiate users;
It is added to prevent diversion and abuse because its effects are felt most acutely when the pills are crushed in order to be injected intravenously.
![Page 72: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/72.jpg)
BuprenorphineThe FDA said Subutex should be used at the
beginning of treatment, while Suboxone should be used for maintenance.
![Page 73: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/73.jpg)
![Page 74: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/74.jpg)
![Page 75: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/75.jpg)
![Page 76: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/76.jpg)
![Page 77: Natural Alkaloids : occur naturally in Opium](https://reader035.vdocument.in/reader035/viewer/2022062422/56813080550346895d9659ed/html5/thumbnails/77.jpg)