Solutio Morphini hydrochloride 1% et 5% pro injectionibus
International nonproprietary name
Morphine.
Pharmatherapeutic Group
Narcotic analgesics.
Formulation
1 ml of solution for injections contains 10 mg or 50 mg of morphine.
Pharmacological Action
Pharmacodynamics
Morphine is a basic representative of narcotic analgesic group, it is remarkable for its powerful analgetic effect. It has an antishock action at injuries and inhibitory action to conditioned reflexes, settles summational ability of central nervous system, enhances effect of narcotic, somnific and local anaesthetic drugs. It settles excitability of cough centre.
Pharmacokinetics
The preparation is rapidly absorbed in blood by any method of introduction. It easily passes barriers including hematoencephalic, placental ones. It is metabolized forming mainly glucoronides and sulfates. It is excreted by kidneys, in minor quantities it is excreted by endocrine glands.
Therapeutic Indications
Morphine is used as an analgetic drug at injuries and different diseases accompanied with powerful sensation of pain (malignant neoplasms, myocardial infarction and etc.), while preparing of patient for surgery and during postoperative period, at insomnia caused by severe pains, sometimes at powerful cough, dyspnea stipulated by acute cardiac decompensation.
Sometimes Morphine is used in radiological practice during examination of stomach, duodenum, gallbladder. Morphine introduction increases muscular tonus of stomach, enhances its peristalsis, accelerates gastric evacuation and cases dilatation of duodenum by contrast substance. It promotes to reveal gastric ulcer and tumor of stomach, ulcer of duodenum.
Contraction of Oddi's sphincter muscle caused by Morphine creates favorable conditions for radiological exploration of gallbladder.
Direction for Use and Dosage Schedule
Morphine is prescribed for subcutaneous introduction (for adults usually 1ml of 1% solution).
For children over 2 years Morphine is prescribed depending on their age in 0.001-0.005 g per dose.
For children under 2 years morphine is not prescribed.
Maximum dose for adults (intake and subcutaneous infusion): single dose – 0.02 g, daily dose – 0.05 g.
Patients suffering acute and chronic pains Morphine is introduced peridurally ( with observance of the required precautions at this method of introduction) with 0.2-0.3-0.5 ml of 1% solution of Morphine in 10 ml of isotonic solution of sodium chloride. The effect declares itself in 10-15 minutes; in 1-2 hours their analgesic effect is most evident and preserves within 8-12 and more hours.
Particular Indications
When passing through placental barrier it may cause depression of fetus respiratory centre and that’s why it is not used for labor pain relief.
Adverse Reaction
Using of morphine may cause vomiting, nausea, respiratory depression, constipation and other adverse effects connected with peculiarities of its influence to various organs and systems of organism.
In case of long-term administration development of Morphine dependence is quite possible.
Contraindications
Apparent extreme emaciation, respiratory failure, infancy under 2 years.
Precautions
Patients of old age are prescribed Morphine with care.
Interaction with other drugs
Morphine prolongs and enhances effect of drugs, causing depression of central nervous system.
OverDose
Symptoms: the earliest and the most dangerous manifestation is depression of respiratory center.
Treatment: General resuscitation measures. Prescription of antagonists and agonists-antagonists of opioid receptors ( first of all – of naloxone).
Form of Production
1% and 5% solution for injections in ampuls containing 1 ml. 10 ampuls in boxes.
