|
International generic name
Morphine
Drug form and composition
Solution for injection. One ampoule of 1 ml contains 10 mg (1%) or 20 mg (2%)
Morphine hydrochloride.
Indications
The preparation is used in patients with severe pain due to myocardial infarction;
acute pulmonary edema; malignant diseases in terminal phase; large traumatic injuries;
surgery.
Dosage and administration
The preparation is applied parenterally - intramuscularly (preferable), subcutaneous
or intravenously. In adults: intramuscularly or subcutaneous, 5-20 mg every 4 hours,
if necessary. Intravenously the preparation is applied in dose 5-10 mg, diluted
in 5 ml sterilized water for injections. Maximal dose is 50 mg /24 hours. In children
Morphine is applied subcutaneous in dose 0.1-0.2 mg per kg body weight. The preparation
could be applied as a continuos intravenous infusion in doses 0.05-0.1 mg per kg
body weight. Maximal dose is 7.5-15 mg /24 hours.
Contraindications
The preparation should not be used in following conditions: children younger
than 5 years; respiratory center disorders; alcohol psychosis; pregnancy and nursing;
anoxia; pulmonary edema; bronchiolitis; brain edema; myxedema; acute abdomen. The
preparation should not be used in drivers and machinery operating persons.
Special warnings and precautions
The treatment with Morphine may lead to bradycardia, vomiting, and spasms of
the sphincters. In order to avoid the side effects atropine (subcutaneously) should
be applied simultaneously. The preparation should be applied with care in following
conditions: emotional disorders or suicide thoughts; following gastrointestinal
surgery, in order to avoid an intestinal motility disorders; liver disorders; hypothyroidism;
intestinal inflammations; prostatic gland hypertrophy or urinary tract obstruction;
urethral stricture; following urinary tract surgery; renal function disorders; reduced
respiratory reserve. In elderly patients and patients with debility the preparation
should be used with exceptional care. In long-term treatment Morphine hydrochloride
leads to mental and physical dependence.
Drug interactions
Morphine effects are potentiated in concomitant application of following preparations:
alcohol; general anesthetics; sedative and hypnotic drugs; neuroleptics; antiepilepsy
and antihystamine preparations. Alkalizing agents reduce excretion of Morphine in
urine.
Adverse reactions
Morphine may lead to heart rate slowing; cardiovascular collapse; headache; dizziness;
tremor; coordination disorders; impotence; respiratory center depression; brain
edema in cranial injuries; abstinence with mental disorders; xerostomia; nausea;
vomiting; abdominal pain; constipation; dyspnea; oliguria; urine retention; glycosuria;
scarlatina-like, measles-like, vesicular, and bullous rash; itching; dermatitis;
hypothermia.
Pharmacological mechanisms
Morphine, being a piperidine-phenantrene opium alkaloid, belongs to the group
of narcotic analgesics. It possesses a powerful central analgesic effect. It has
also an euphoric effect, manifesting with high spirits, sence of emotional comfort,
lack of fear, hopelessness, and ill succsess. Morphine enhances the pain treshold
and significantly depresses the CNS capabilities to summarize the under-threshold
excitations. The long-term administration of Morphine significantly increases the
risk of accustoming and addiction.
Supplied
10 or 100 ampoules of 1 ml (10 mg and 20 mg).
Expiry
3 years.
|