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Materials and methods Chemicals and reagents Gold(III) chloride trihydrate (HAuCl3 HO), hydrogen peroxide (HO), and dimethyl sulfoxide (DMSO) were purchased from Merck Chemicals, India

Pharmacokinetics Routes: IV, IM, transdermal patch, transmucosal (lozenge, buccal, nasal spray) Onset: Rapid (within minutes when given IV) Duration: Short (3060 minutes IV), longer with transdermal patch Metabolism: Hepatic (CYP3A4 enzyme) Elimination: Renal (mostly metabolites) Clinical Uses Pain management: Severe, chronic pain (especially cancer pain) Anesthesia: Induction and maintenance of anesthesia, adjunct to general anesthesia Procedural sedation: In ICU or emergency settings Postoperative pain (controlled settings only) Adverse Effects Respiratory depression (most serious) Sedation, dizziness Nausea, vomiting, constipation Bradycardia, hypotension Tolerance and dependence with prolonged use Contraindications Hypersensitivity to fentanyl Respiratory depression or severe asthma Paralytic ileus (for transdermal use) Precautions Use with caution in elderly, hepatic impairment, or patients with COPD

The GSH:GSSG ratio reflects how well your body is managing oxidative stress