Dextrométhorphane

The dextrométhorphane (or dextrogyre isomer of lévométhorphane) is a Analgésique Opiacé, used like Médicament against cough. It is also diverted of its medical use for its effects Psychotrope S with strong amount and, DXM is then usually called.

History

The dextrométhorphane is used to look after cough, for the first time in 1958 with the the United States then in the rest of the world. At the origin presented in Compressed, the product is withdrawn from the sale in 1973 in the USA because of its diverted use.

The drug reappears in 1977 in the form of Sirop, more difficult to introduce in great quantities. Only some amateurs continue to use it in manner diverted during the Années 1980 - 1990.

Several cases of death (mainly in the USA) are charged to the entertaining consumption of the dextrométhorphane.

Chemistry

The dextrométhorphane is used in the form of salt of bromohydrate of dextrométhorphane (C₁₈H₂₆BrNO, molar H₂O/mass = 303.7 g/mol), crystalline, white, water soluble powder and in the ethanol. Its melting point is approximately of 125 °C with a decomposition of the substance

Pharmacology

With strong amounts, it is anesthetic dissociative.

The DXM, once in the organization, must be transformed by a Enzyme into DXO to be psychoactive. However this enzyme is inactive in a very small percentage of the population at which the DXM thus does not act.

Medical use

It is used like Médicament Antitussif.

Posology

With low dose, that is to say between 15 and 20 Mg, the dextrométhorphane can raise the threshold of the Toux and this, for four to six hours. It is also possible to take an amount slightly larger, that is to say nearly 30 Mg to have an effect from four to six hours. However, 120 should not normally be exceeded Mg per day.

With regard to the children, the amount recommended is from 0,2 to 0,4 Mg per kilogram per amount (to the four to six hours) with a maximum of 60 Mg by 12 midnight.

It is necessary to be vigilant when one tries to inhibit cough. Normally, it is about a reflex to release the respiratory tracts. When this reflex is inhibited, all secretions are found in the lungs, bronchi and trachea. It is recommended to take the dextrométhorphane in end-of-day rather, in order to leave time to the organization to drive out secretions of the organization.

Medicamentous interactions

The dextrométhorphane reacts with others Médicament S, that is to say the IMAOs, the Paroxétine, the Fluoxétine, the Sélégiline and the Quinidine.

The Fluoxétine (Prozac©) is an inhibiter of the cytochrome P450 2D6 and the dextrométhorphane is metabolized by this cytochrome. Thus the metabolisation does not take place quite simply and there can be an accumulation in the body and a Toxicité is possible.

When the patient consumes such products, it is advised to move towards the Chlophédianol, marketed under the name of Ulone .

Diverted and entertaining use

The dextrométhorphane is contained into small quantities in syrups against the toux.
Certain users absorb syrup in important quantity with an aim of obtaining an effect Psychotrope. Some deaths were related to the consumption of great quantities of syrup containing of the dextrométhorphane.
Other users try to extract the dextrométhorphane from syrup, using a relatively complex Procédé.

The Combustion of the dextrométhorphane in the presence of Oxygène produces substances highly Toxique S. the amateurs of Free bases - DXM often use sprays to mitigate this.

Interactions

The combined use of dextrométhorphane with other products can be dangerous, in particular with the inhibiters of the monoamine oxydases (IMAO), a group of Antidépresseur s.
Thus, a user having consumed of IMAOs in the fourteen days preceding the catch by dextrométhorphane expose himself to dangerous interactions.

These effects can induce a syndrome serotoninergic which potentiates the effects of MDMA in the event of combined consumption.

Effects and consequences

The psychotropic effects include/understand a space-time confusion, feelings the extraone, a driving incoordination, Hallucination S.

The physical effects can induce nausea S, Vomissement S, a Hyperthermie, cutaneous itchings. Nevertheless its diverted use remains generally condemned by the laws.

Close molecules

Because of its character of dissociative anesthetic, it induces effects Psychotrope S, similar to those induced by the Kétamine or PCP.

References

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