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2nd Term 8th Lecture
2nd Term 8th Lecture

...  Tolerance to opiates (i.e. an increase in the dose needed to produce a given pharmacological effect) develops within a few days. To reproduce the original response, a larger dose must be administered. Tolerance includes analgesia, emesis, euphoria and respiratory depression, but affects the consti ...
Pain and Opioid (Narcotic) Analgesics
Pain and Opioid (Narcotic) Analgesics

... spasm of sphincter of Oddi. Sometimes biliary colic is worsened by morphine. In patients who have had a cholecystectomy morphine can produce a syndrome sufficiently like an acute myocardial infarction and this may cause diagnostic confusion; naloxone may give dramatic relief, as may glyceryl trinitr ...
analg_opioide_Engl_2013
analg_opioide_Engl_2013

... Opioid Analgesics-Pethidine  Pethidine/meperidine and fentanyl are the most widely ...
Option D past paper questions 1. Aspirin, paracetamol
Option D past paper questions 1. Aspirin, paracetamol

... small doses. Other than the possibility of death, outline the problems associated with taking larger doses of paracetamol. [2] (d) State one important use for aspirin other than the relief of pain and fever. [1] (e) Other than the phenyl group, state the name of one other functional group that is co ...
Origins of Medicinal Chemistry
Origins of Medicinal Chemistry

... Fraser and Brown make quaternary salts of many different alkaloids (i.e, morphine, strychnine, nicotine) and find that all exhibit curare-paralyzing ...
Document
Document

... extended duration of action in suppressing withdrawal symptoms in physically dependent individuals, and its tendency to show persistent effects with repeated administration. Miotic and respiratory-depressant effects can be detected for more than 24 hours after a single dose and, upon repeated admini ...
Morphine Sulfate USP Powder
Morphine Sulfate USP Powder

... alkaloid. It is the principal alkaloid of crude opium, which is a resinous prep of the opium poppy, Papaver Somniferum. It is present in opium at approximately 10%. Morphine Sulfate is the principal salt of morphine and a world-wide standard for pain treatment. Morphine Sulfate is a strong analgesic ...
Uppers, Downers & All Arounders
Uppers, Downers & All Arounders

... – Therapeutic pain control – Patient become more sensitive to pain after long-term use because the body produces fewer of its own painkillers – Down regulates opioid receptor sites ...
Introducing new research results in daily clinical practice: how much
Introducing new research results in daily clinical practice: how much

... ¾ Similar opioid switching rate. ¾ No differences in pain intensity were observed. ¾ OEI lower with methadone(
Acute Pain Management in the Opioid Dependent Patient
Acute Pain Management in the Opioid Dependent Patient

... (Bedside) to bench to bedside  since opioids were first used for the treatment of acute pain Across the life span  from newborn to elderly Newer ‘bench to bedside’ developments ...
АНАЛГЕЗИВНІ ЗАСОБИ
АНАЛГЕЗИВНІ ЗАСОБИ

... • Acts longer than morphine (approximately 6 hours) • Analgesic activity is higher than of morphine, that’s why it’s used in doses of 0,3-0,6 mg • In case of breathing depression, which it causes, naloxon is less effective since buprenorphine is slowly released from the connection with mu-receptors ...
Narcotics
Narcotics

... Other synthetic opiates include meperidine (Demerol), propoxyphene hydrochloride (Darvon) and Methadone. Oxycontin is a strong opoid that offers long pain relief. A popular drug in Appalachia and has been referred to as “hillbilly heroin” ...
File
File

...  Even though pain in the affected tissue is still occurring and being transmitted via the peripheral nervous system, the patient is not as aware of it ...
Pain control and controlled drug prescribing
Pain control and controlled drug prescribing

... 75mcg/hr fentanyl patch. It takes 12-24 hours after a fentanyl patch is started to reach steady state and 12-24 hours after a patch is removed for the reservoir of drug in the skin to be depleted. When changing from a syringe driver to a patch, keep the driver going for approx 12 hours after the pat ...
Fentanyl Is Superior To Morphine
Fentanyl Is Superior To Morphine

... Anesthesiology and Acute Pain Service for patients in any location when ICU standards are not in effect. 2. IV PCA fentanyl for patients on the regular floors, intermediate care, or ICUs managed by the Acute Pain Service. Contact Brenda Perry RN at 756-2270 3. For conscious sedation for invasive pro ...
2 MB - opioids_
2 MB - opioids_

... • Its high affinity and selectivity for μ opioid receptors have made it a common probe for μ effects in pharmacologic studies. ...
What’s In this Urine?
What’s In this Urine?

...  Target analyte: morphine  *See Figure 2 for opiate/opoid metabolic pathways  Methadone, fentanyl, propoxyphene, naloxone, 6-MAM present naltrexone, and tramadol are not detected by opiate IA or only 2-8 hours confirmation. post heroin use  *Oxycodone, hydrocodone, hydromorphone oxymorphone do n ...
References - Society of Anesthesia and Sleep Medicine
References - Society of Anesthesia and Sleep Medicine

... in children. It is not affected by CYP2D6 enzyme activity and in adults is known for its reduced gastrointestinal side-effects compared to other opiates. Guidelines for opiate administration in the presence of moderate to severe OSA should include appropriate monitoring, a 50% reduction in dose, avo ...
Analgesic Drugs
Analgesic Drugs

... to active or inactive metabolites & are excreted in the urine or bile Most Opiods have a volume of distribution several times greater than total body water. Total clearance similar to hepatic blood flow. Entero- hepatic circulation is present for Morphine metabolites. May accumulate & cause respirat ...
Print
Print

... Begins within 24 hours after the last dose Increase in severity over the next 72 hours. Most gone after 33-5 days, Some symptoms ...
also see p. S21 - Viktor`s Notes for the Neurosurgery Resident
also see p. S21 - Viktor`s Notes for the Neurosurgery Resident

...  long duration of action (up to 6 h); respiratory depression not fully reversible with NALOXONE!  increasingly used for opiate dependence treatment.  BUTRANS® - FDA approved once-weekly buprenorphine transdermal system for moderate to severe chronic pain in patients requiring continuous, around-t ...
Pharmacy Intro
Pharmacy Intro

... Opioids and other drugs we use on palliative care ...
OPIATE ANALGESICS AND ANTAGONISTS
OPIATE ANALGESICS AND ANTAGONISTS

... – Used in methadone maintenance programs for treatment of opioid addicts and for opiate withdrawal syndrome(it reduces the physical abstinence syndrome)make it possible to wean the addict from opioids. ...
Equivalent dose ratios for opioids Oral morphine
Equivalent dose ratios for opioids Oral morphine

... e.g. 20mg injectable diamorphine : 2mg injectable alfentanil Reminder If a drug is stronger, the dose required is smaller For conversions from one alternate opioid to another, direct conversion ratios are not so reliable. The preferred method is to convert drug A to oral morphine then go from oral m ...
Intra-articular injection of morphine: may it play a role? Serbülent
Intra-articular injection of morphine: may it play a role? Serbülent

... Morphine is highly addictive when compared other substances, and tolerance and physical and psychological dependents develop very rapidly. ...
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Morphine



Morphine, sold under many trade names, is a pain medication of the opiate type. It acts directly on the central nervous system (CNS) to decrease the feeling of pain. It can be used for both acute pain and chronic pain. Morphine is also frequently used for pain from myocardial infarction and during labour. It can be administered orally, intramuscularly, subcutaneously, intravenously, into the space around the spinal cord, or rectally. Maximum effect is around 20 min when given intravenously and 60 min when given by mouth while duration of effect is between three and seven hours. Long acting formulations also exist.Potentially serious side effects include a decreased respiratory effort and low blood pressure. Morphine has a high potential for addiction and abuse. If the dose is reduced after long term use withdrawal may occur. Common side effects include drowsiness, vomiting, and constipation. Caution is advised when used during pregnancy or breast feeding as morphine will affect the infant.Morphine was first isolated between 1803 and 1805 by Friedrich Sertürner. This is generally believed to be the first isolation of an active ingredient from a plant. Merck began marketing it commercially in 1827. Morphine was more widely used after the invention of the hypodermic syringe in 1853–1855. Sertürner originally named the substance morphium after the Greek god of dreams, Morpheus, for its tendency to cause sleep.The primary source of morphine is isolation from poppy straw of the opium poppy. In 2013 an estimated 523,000 kilograms of morphine were produced. About 45,000 kilograms were used directly for pain, an increase over the last twenty years of four times. Most use for this purpose was in the developed world. About 70% of morphine is used to make other opioids such as hydromorphone, oxycodone, heroin, and methadone. It is a Schedule II drug in the United States, Class A in the United Kingdom, and Schedule I in Canada. It is on the WHO Model List of Essential Medicines, the most important medications needed in a basic health system.
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