Morfine

Morfine – 10 mg / ml Solution for injection

Morphine is a narcotic analgesic that causes analgesia mainly centrally than peripherally in the perception of pain. It also acts in the smooth muscles by increasing the tonus, especially of the sphincters of the gastrointestinal tract by reducing peristalsis. The pharmacological effects of morphine are: analgesia, drowsiness, behavioral changes (euphoria), lowering of body temperature and depending on the dose even respiratory depression.
Cough suppression is caused by the direct effect in the medullar center.
Morphine is readily absorbed after intramuscular and subcutaneous injection. Maximum plasmatic levels appear within 30 minutes of the intramuscular injection. Morphine is rapidly distributed in the body but mainly in the parenchymatous tissue such as in the kidneys, liver and spleen. Lower concentrations are found in the skeletal muscles. Small amounts of morphine cross the hematoencephalic barrier. Morphine does not remain for a long time in the tissues and 24 hours after receiving the last dose, the concentrations are quite low. Morphine passes through the placenta and its traces are found in sweat and in breast milk. About 33% of the drug is bound with proteins, mainly with albumin. Morphine is metabolized mainly in the liver by conjugation with glucuronic acid in the 3 – hydroxyl group and in a lesser extent in the 6 – hydroxyl group. The elimination half-life is about 1.5 to 2 hours in healthy subjects and 90% of the dose is excreted through urine within 24 hours. About 7 to 10% of the dose is excreted through faeces. There is evidence that urinary excretion of morphine may be increased by lowering the pH of urine.

Morfine is used in:
• the relief of moderate to severe pain, in malignant tumors, after severe trauma, after surgeries and myocardial infarction;
• cardiac asthma;
• acute pulmonary oedema;
• peripheral vascular obstruction;
• traumatic shock;
• pulmonary embolism;
• abdominal, renal and biliary colics;
• pretreatment before general anaesthesia.
Morphine is also used in other emergencies such as in left ventricular failure, abdominal perforation and haematemesis.
Morphine alleviates the anxiety associating severe pain and it is used as hypnotic in case sleeplessness is caused by pain.