| Drug Index |
| GENERIC NAME : |
| morphine |
| BRAND NAMES : |
| Avinza, M.O.S., MS.IR, ratio-Morphine, Statex , M.O.S.-SR, M-Eslon, Roxanol, MS Contin, Oramorph SR, PMS-Morphine Sulfate SR, ratio-Morphine SR, ratio-Morphine, Kadian |
| STREET NAMES : |
| dreamer, miss emma, morf hows, M |
| BRIEF DESCRIPTION : |
| Morphine is a narcotic analgesic (painkiller) and antitussive (cough suppressant) that binds to the mu(μ) opiate receptor. It is an opioid agonist. It is considered a central nervous system depressant. Examples of other opioid agonists include substances such as hydrocodone, hydromorphone, fentanyl, codeine, and oxycodone. Morphine sulfate is supplied in short acting tablets, slow release tablets and parenteral (injectable) forms. Extended-release tablets are controlled-release tablets containing morphine sulfate. Following oral administration of a given dose of morphine, the amount ultimately absorbed is essentially the same whether the source is sustained (extended) release or a conventional formulation. Morphine is released from extended-release tablets more slowly than from conventional oral preparations. Although a small fraction (less than 5%) of morphine is demethylated, for all practical purposes, virtually all morphine is converted to glucuronide metabolites; among these, morphine-3-glucuronide is present in the highest plasma concentration following oral administration. NOTE: This summary will focus solely on morphine and will not include descriptions of all the various short, long acting and parenteral forms of this medication. For details on this please refer to other resources listed at the end of this article. |
| INDICATIONS FOR USE : |
| Morphine is supplied short acting form (rapid release tablets, rapid release liquid or injectable) for the treatment of pain moderate to severe acute pain. It also causes sedation. Long-acting forms are generally reserved for chronic pain. |
| ABUSE AND ADDICTIVE POTENTIAL : |
Use of morphine poses a high risk for abuse or dependence. It should be used with caution in patients with a history of alcohol or substance dependence as this may highly predisposed to becoming addicted to this drug. A symptom that is easily detected with opiate use is pinpoint pupils (miosis). Psychological dependence may occur early in use of this medication, but physical dependence and tolerance may develop upon repeated administration over several weeks or months (requiring larger or more frequent dosages of morphine to produce relief of pain or achieve a state of euphoria). When morphine is abused, the individual is seeking the euphoric effect ("high"). Mild signs of withdrawal can occur in some individuals after using morphine for several days consecutively. Addiction to this drug can occur, even if taken as prescribed, when used for several weeks or months consecutively. When taken for treatment of chronic pain for several weeks or months consecutively, tolerance and dependence often occur. Once an individual has become dependent on morphine, a primary driving force to continue using morphine (or substituting other opiate agonists) is to prevent the very unpleasant neurochemical and physical withdrawal syndrome associated with discontinuing this drug. Symptoms usually associated with withdrawal may include:  • Abdominal pain  • Muscle aches  • Joint pain  • Sleep problems (insomnia)  • Agitation   restlessness   irritability  • Diarrhea   intestinal spasm  • Dilated pupils • Goose bumps • Nausea  • Runny nose   • Sweating   dehydration  • Vomiting • Restlessness  • Yawning   sneezing  • Loss of appetite (anorexia)  • Rapid heart rate  • Elevated blood pressure or temperature  • Rapid breathing  • Eyes or nose watering (Note: the term “going cold turkey” comes from the gooseflesh that occurs during withdrawal that looks like the skin of a plucked turkey) Withdrawal of morphine is best handled by a physician that is skilled at assisting patients with opiate detoxification. Medications are often necessary to help control symptoms of withdrawal. |
| OVERDOSAGE : |
| Acute overdose of morphine can cause respiratory depression, extreme drowsiness or prolonged sleeping, stupor or coma, muscle flaccidity, cold/clammy skin, constricted pupils, slow heart rate (bradycardia), low blood pressure (hypotension), coma, and death. When morphine is used in combination with alcohol or other central nervous system depressants, the two drugs potentiate one another and can greatly enhance the risk for overdose. Because of the dangers associated with overdose, immediate medical attention should be sought. |
| CAUTIONS : |
| Any patient with a history of alcohol or substance dependence has a very high risk for developing addiction to morphine. If use of this medication is considered necessary for the management of pain, the lowest dose of this medication that is sufficient to provide pain relief is warranted. It is also recommended that use of this medication in an addict be discontinued as soon as possible and pain management thereafter managed with non-addictive medications if possible. Respiratory depression is the chief hazard from all opioid agonist medications. Caution should be exercised when prescribing this medication to individuals with impaired lung function or low blood pressure. There may be serious problems also with use of this medication an individual with a closed head injury. It can elevate cerebrospinal fluid pressure and mask symptoms of closed head injury that could require immediate medical measures. The administration of morphine, like all opioid analgesics, may obscure the diagnosis or clinical course in patients with acute abdominal conditions. Physical dependence and tolerance are not unusual during chronic opioid therapy. Morphine levels are less affected by mild to moderate kidney disease because morphine is primarily metabolized to inactive metabolites. Caution is advised in administering this medication to individuals with severe kidney (renal) or liver (hepatic) impairment and must be monitored closely. The administration of morphine, like all opioid analgesics, may obscure the diagnosis or clinical course in patients with acute abdominal conditions. Morphine also crosses the placental membranes and has been found in breast milk. |
| SIDE EFFECTS : |
| Side effects of morphine use may include nausea, constipation, vomiting, headache, and itching (pruritus). Adverse effects may include allergic reaction, irregular heartbeat, migraine, confusion, dry mouth, nervousness, tremor, rash, blurred vision, mental clouding, lethargy, mood changes, urinary retention, anxiety, fear, respiratory depression, and personality changes. |
| FOR MORE INFORMATION : |
*This is a condensed description of morphine. For more details check with your physician, pharmacist, or resources such as The Physicians’ Desk Reference (PDR) http://www.rxlist.com/script/main/hp.asp |
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