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Lifestyle and Diet
Published in Chuong Pham-Huy, Bruno Pham Huy, Food and Lifestyle in Health and Disease, 2022
Chuong Pham-Huy, Bruno Pham Huy
Morphine is an alkaloid of opium. In medicine, morphine is used mainly to treat acute and chronic severe pain. As heroin, morphine gives euphoria to the drug addict, but its effect is less rapid than that of heroin. Its side effects are similar to those of heroin. Chronic morphine abuse leads to physical and psychological dependence. Morphine withdrawal symptoms in people include sneezing, runny nose, cough, abdominal pain, diarrhea, anorexia, anxiety, and other effects (130). Morphine is rarely used by addicts because its euphoria is less intense than that of heroin.
Critical care, neurology and analgesia
Published in Evelyne Jacqz-Aigrain, Imti Choonara, Paediatric Clinical Pharmacology, 2021
Evelyne Jacqz-Aigrain, Imti Choonara
Fetuses are capable of metabolising morphine from 15 weeks gestation [33,34]. Morphine clearance matures with post conceptual age [27,35], reaching adult values at 6–12 months [15,36]. The increased clearance observed in children, when expressed per kilogram, is a size artifact and not attributable to this age group’s increased liver size (Table 3 and Figure 2). Pharmacokinetics in children have been described: volume of distribution 136 l/70kg (percentage clearance volume, 59.3%), formation clearance to M3G 64.3 l/h/70kg (58.8%), formation clearance to M6G 3.63 l/h/70kg (82.2%), morphine clearance by other routes 3.12 l/h/70kg, elimination clearance of M3G 17.4 l/h/70kg (43.0%), elimination clearance of M6G 5.8 l/h/70kg (73.8%). The volume of distribution of morphine increased exponentially with a maturation half-life of 26 days from 83 L/70kg at birth; formation clearance to M3G and M6G at birth also increased with a maturation half-life of 88.3 days from 10.8 and 0.61 l/h/70kg respectively. Metabolite clearance increased with age (maturation half-life 129 days), similar to that described for glomerular filtration rate (GFR) maturation in infants. M3G elimination clearance is greater than GFR, suggesting tubular secretion and non-renal elimination [37].
Drugs Affecting the Musculoskeletal System
Published in Radhwan Nidal Al-Zidan, Drugs in Pregnancy, 2020
Risk Summary: The use of Morphine should be avoided, if possible, in pregnant women because the pregnancy experience in humans has shown a low risk of congenital birth defects associated with the use of this drug. Furthermore, its use near delivery is associated with a risk of neonatal respiratory depression.
Chronic Pain: A Case Application of a Novel Framework to Guide Interprofessional Assessment and Intervention in Primary Care
Published in Canadian Journal of Pain, 2023
The author’s assessment involved gathering the patient’s history and completing a medication review. The patient’s morphine equivalent dose (MED) was calculated at 82.5 mg of morphine daily, just below the maximum dose of 90 mg daily recommended by the Canadian “Guideline for opioid therapy and chronic noncancer pain.”7 The Opioid Risk Tool was completed and the patient scored a 7, indicating moderate risk of opioid abuse.8 The patient was also asked to complete several PROMs during this assessment,9–15 the results of which were used as data in applying Walton and Elliott’s framework.6 They included the Brief Pain Inventory Short Form (BPI-SF),9 which measures pain severity and impact on function; the Brief Illness Perception Questionnaire (BIPQ),10 which assesses the emotional and cognitive representations of illness; the Pain Catastrophizing Scale (PCS),11 which assesses pain-related catastrophic thinking; and the Depression, Anxiety, and Stress Scale (DASS21),12 which measures levels of depression, anxiety, and stress. Additional PROMs included the Central Sensitization Inventory (CSI),13 which measures symptoms commonly associated with central nervous system hypersensitivity; the Self-Administered Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS),14 which is used to identify neuropathic pain symptoms; and the Tampa Scale for Kinesiophobia (TSK),15 which measures fear of movement and reinjury. Once they were completed by the patient, they were reviewed and scored by the author.
The effects of morphine on vascular cell adhesion molecule 1(VCAM-1) concentration in lung cancer cells
Published in Archives of Physiology and Biochemistry, 2023
Ahmad Ghasemi, Golnaz Vaseghi, Alaei Hojjatallah, Shaghayegh Haghjooy Javanmard
For several years, morphine has been used to induce analgesia and relieve pain in patients with cancer (Maher et al. 2020). It has been shown that morphine not only acts through opioid receptors (McDonald and Lambert 2015)but also it can activate other pathways (Vaseghi et al. 2012) such as TLR4 (Haghjooy-Javanmard et al. 2018, Maher et al. 2020). Despite extensive research, it is still not clear how morphine affects the cancer cells. Some studies have shown that morphine can increase tumour growth and decrease survival rates (Niu et al. 2015), but others have demonstrated that morphine may prevent cancer growth and metastasis (Gach et al. 2011). It seems that morphine also plays a dual role in the regulation of tumour metastasis. However, the mechanisms remain uncertain.
Research progress of p38 as a new therapeutic target against morphine tolerance and the current status of therapy of morphine tolerance
Published in Journal of Drug Targeting, 2023
As a powerful opioid analgesic, morphine is widely used in intraoperative anaesthesia, postoperative analgesia, severe pain treatment and the third step pain relief of malignant tumours. Between 2004 (25,644 S-DDD (defined daily doses for statistical purposes) and 2019, (27,957 S-DDD), the global trend in morphine usage stayed relatively consistent, but grew to 31,824 S-DDD in 2020, the greatest consumption in over a decade. In 2020, 35.3 tons (11.4%, up from 9.4% in 2019) of morphine were used directly, primarily for palliative care [1]. Morphine tolerance is becoming increasingly common as a result of long-term and extensive usage, resulting in poor effectiveness, hyperalgesia, and even adverse effects such as low mood, nausea or vomiting, respiratory suppression, and so on [2]. Morphine tolerance is the main reason for the weakening of pain control and the increase of dose [3,4]. Seriously affect the safety and comfort of patients.