Morphine

Morphine is a narcotic analgesic. Morphine is the principal alkaloid obtained from the unripened seed capsules of the opium poppy, Papaver somniferum. It was first isolated in 1803 and is the prototype of the opiate agonists. Today, the poppy is still the source of the drug because synthesis of Morphine is difficult. Morphine is available for administration as the hydrochloride or sulfate salt in all dosage forms. It sulfate is a strong analgesic used primarily for the relief of severe pain. Higher doses are useful for preoperative sedation and as a supplement to anesthesia. Morphine is also used for analgesia during labor. The effect on uterine contractions depends on the stage of labor when Morphine is administered. Morphine is the drug of choice for pain associated with myocardial infarction. it, as well as other opioids, can produce euphoria, feelings of well being, and tranquility, subjecting them to abuse. All opioid drugs can cause physical dependence, so their use is restricted. Morphine is a schedule C-II controlled substance and was in use for many years prior to its approval by the newly-formed FDA in 1939. Another dosage form, MorphiDex, is nearing the end of phase III investigation as of May 1997. It stimulates µ, ? receptors with little or no activity on sigma and delta receptors. Clinically, stimulation of µ and ? receptors produces analgesia, euphoria, respiratory depression, miosis, decreased gastrointestinal motility, and physical dependence.


Adult Dose
Dose: 5 to 15 mg
Single Dose: 10 (10)
Frequency: 4 hourly
Route: IM
Instructions:
Neonatal
Dose: 0.1 to 0.2 mg/kg
Single Dose: 0.15 (0.15)
Frequency: 4 hourly
Route: Intra Muscular
Instructions: -
Paedriatic
Dose: 0.1 to 0.2 mg/kg
Single Dose: 0.15 (0.15)
Frequency: 4 hourly
Route: Intra Muscular
Instructions: -
Characteristics
Morphine Sulphate is the derivative of Morphine. It is of Natural origin and belongs to Alkaloid. It belongs to OPIATE agonist pharmacological group on the basis of mechanism of action and also classified in Analgesic-Narcotic pharmacological group.The Molecular Weight of Morphine is 303.40. Its pKa is 7.93, 9.63.
Contraindications
Morphine is contraindicated in conditions like Respiratory disease,Biliary colic,Raised intracranial pressure,Coronary perfusion disorder,Head injury.
Effects
The severe or irreversible adverse effects of Morphine, which give rise to further complications include Dependency.Morphine produces potentially life-threatening effects which include Coma, Respiratory depression, Anaphylactic shock, Cyanosis. which are responsible for the discontinuation of Morphine therapy.The signs and symptoms that are produced after the acute overdosage of Morphine include Hypotension, Coma, Hypothermia, Tremor, Dysphoria, Sedation, Respiratory failure, Nausea & vomiting.The symptomatic adverse reactions produced by Morphine are more or less tolerable and if they become severe, they can be treated symptomatically, these include Nausea, Restlessness, Constipation, Urinary retensionX, Urticaria, Pruritus, Itching, Hallucination, Postural hypotension, Nausea and vomiting, Hyperactivity, Biliary spasm, Mental clouding, Asthma.
Indications
'Morphine is primarily indicated in conditions like Acute pain, Acute pulmonary oedema, All forms of epilepsy, Chronic pain, Cough, Dyspnoea (breathlessness at rest) in palliative care, GI motality disorder, Insomnia, Intractable cough in palliative care, Myocardial infarction, Myoclonus, Pain, Parkinson''s disease; drug-induced extrapyramidal symptoms, Pituitary desensitisation, Post-operative pain, Severe acute pain, and can also be given in adjunctive therapy as an alternative drug of choice in Dyspnea, Dysponea, Pain in palliative care, Surgery.'
Interactions
Morphine is known to interact with other drugs, the details of drug interactions is as follows:DrugDetailsSeverityOnsetManagementAlcoholBromazepamCarbamazepineChlordiazepoxide (HCl)Cimetidine (HCl)Dexamphetamine (Sulphate)Dexamphetamine (Sulphate)DisulfiramEnfluraneEsmololHalothaneHydroxyzineKetorolac (Tromethamine)LevorphanolNitrous OxidePralidoximePrazepamPropofolMorphine may increase the anesthetic or sedative effects of Propofol.The induction dose requirements of Propofol Injectable Emulsion may be reduced in patients taking morphine. These interactions are sometimes beneficial and sometimes may pose threats to life. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.
Interfrence
Lowry Method of Protein Estimation Zimmerman procedure for Urinary 17-Ketosteroid determination
Risks
Drug should not be given to patients suffering from Kidney dysfunction.If prescribing authority justifies the benefits of the drug against the possible damages he/she should reevaluate them and consult the reference material and previous studies.
Storage
Inj Store Below 40°C. Do not Freeze. Protect from Sunlight.
Warnings
Morphine should be used with caution in patients with central nervous system (CNS) depression, convulsive disorder, ulcerative colitis, fever, recent gastrointestinal (GI) surgery, bradyarrhythmias, supraventricular tachycardia, pulmonary diseases. Patients should exercise caution while driving or performing tasks requiring alertness because it may produce drowsiness.
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