Morphine

 

05142854568316

 

Morphious→Goddess of dream(Greek mythology)

Morphine produce euphoria.

Chemical nature:Alkaloid.

Pharmacological effects:

(1)Central effects:

[A]Selective depression of CNS:

  1. Analgesia.
  2. Hypnotic effect(sleep).
  3. Respiartory depression.
  4. Cough suppression(anti-tissue effect)
  5. Inhibition of VMC.

[B]Selective stimulation of CNS:

  1. Vagal nucleus:Bradycardia.
  2. Spinal cord:Convulsion,

[C]Changes of the mood=Euphoria or dysphoria.

[D]Dependency.

(2)Peripheral effects:

a. GIT:Morphine causes constipation by:

  • ↑GIT tone.
  • ↓Peristalic movement.
  • Endocrine:
  • ↑ADH,Prolactin.
  • ↓LH.
  1. Biliary tract:
  • Constriction of smooth muscle (Spasm)→Biliary colic.
  • Constriction of sphincter of Oddi.
  1. Ureter & bladder:
  • ↑ Ureteral & bladder tone.
  • ↑Sphincter tone=Urinary retention.
  1. CVS:
  • Dilation of resistance &Capacitance vessels by central action.

Indications:             

  1. Sever somatic pain.
  2. Acute LVF,acute pulmonary oedema.
  3. Pre-anaesthetic medication.
  4. Non-specific diarrhoea.
  5. Suppression of cough.
  6. Acute MI.
  7. Obstructive labour.
  8. Diagnosed abdominal pain.

Contraindications/Opioid analgesic:

  1. Undiagnosed acute abdominal pain.
  2. Head injury.
  3. Extreme age.
  4. Liver diseae,kidney disease.
  5. Pt of poor respiratory reseve-Asthma,Bronchiectasis.
  6. Hypothyroidism.
  7. Convulsive disorder.
  8. Renal colic.
  9. Pregnancy
  10. Addision’s disease.

Adverse effects:

  1. Tolerance.
  2. Addiction.
  3. Constipation.
  4. Vomating.
  5. Respiratory depression.
  6. Bradycardia.
  7. COnvulsion.
  8. Loss of appetite.
  9. Postural hypotension.

**Morphine is contraindicated in poor respiratory resreve because morphine causes release of histamine from mast cells,basophil which causes=Bronchoconstriction, ↑Bronchial secretion.So single dose of morphine is sufficient to rest the pt of astham for ever.

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