MORFIN (Morphinum).

     Applied morphine hydrochloride (Morphini hydrochloridum).

     Synonyms : Morphine hydrochloride, Morphinum hydrochloricum

     The white needle crystals or a white crystalline powder; Slightly zhelteyuschy storage. Slowly soluble in water, soluble in alcohol difficult (1:50). Compatible with alkali. Solutions to sterilize + 100 C for 30 minutes, to stabilize adds 0,1 said. hydrochloric acid solution to pH 3, G-3, 5.

     Morphine is the main representative of a drug analgetikov. He is a strong pain-relieving effect. Anxiety decreases pain centers, it has also protivoshokovoe of injuries. In high doses, is the effect of sleeping pills, which is more pronounced in sleep disorders, feelings of pain.

     Morphine is expressed euphoria, and with the use of re-growing pain of addiction (morphinism).

     Morphine has a braking effect on conditional reflexes, the ability of central nervous system lowers summatsionnuyu increases of drugs, sleeping pills and mestnoanesteziruyuschih funds. It reduces anxiety kashlevogo center.

     Morphine is the initiation centre steel nerves with the advent of aetiology. As a result of the activation of neurons oculomotor nerve under the influence of morphine in humans appears excessive. These effects are removed atropine or other holinolitikami.

     Vomit, which may occur in the application of morphine, deals with the prosecution hemoretseptornyh launchers (trigger) suffering brain areas (see Rvotnye and antiemetics means of a central). Morphine oppresses emetic center, so repeated doses of morphine and material resources, imposed after the morphine did not cause vomiting.

     Under the influence of morphine rising tone smooth muscles of internal organs. There is increasing tone sfinkterov gastrointestinal tract, improving tone muscles antralnoy part of the stomach, thin and thick divisions intestines, weakened Peristalsis, slowed movement of food masses, which leads to constipation. It causes muscles gallons of tumours and Oddy. Increasing tone sfinkterov bladder. Muscle tone may increase with the development of bronchial bronhiolospazma.

     Under the influence of morphine hampered secretory activity of the gastrointestinal tract. In connection with the allocation of antidiuretic hormone stimulation may decrease mocheotdeleniya.

     The main exchange and body temperature under the influence of morphine reduced.

     Characteristic of morphine is the oppression of the respiratory centre. Small doses cause ischemia and increased respiratory movements; High doses provide further ischemia and reduce the depth of the decline in pulmonary respiration ventilation. Toxic doses trigger periodic breathing type Chain-Stokes, then stopped breathing.

     The possibility of drug development and respiratory depression are major weaknesses of morphine, in some cases, limiting the use of its powerful analgeziruyuschih properties.

     Morphine is rapidly absorbed as when administered, and in subcutaneous introduction. Effects develops after 10 to 15 min after the introduction into the skin, and after 20 to 30 min after oral. Effects of single dose continues 3 - 5 hours

     Morphine has an applied as a means of injuries and diseases, accompanied by strong feelings of pain (neoplasia, myocardial infarction, etc.), in preparation for the operation and aftercare period, with insomnia associated with severe pain, sometimes in heavy coughing, severe dyspnoea due to severe congestive heart failure.

     For anesthesia delivery morphine is not normally used, as it passes through the placental barrier and can cause respiratory depression in the newborn.

     Morphine is sometimes used in radiological practice in the study of gastric, duodenal ulcer, gall bladder. Introduction morphine improves muscle tone stomach, increases its peristaltiku accelerates its emptying and cause tensile pot bowel contrast substances. This helps detect tumors and stomach ulcer, duodenal ulcer gut. Morphine induced decrease muscle tumours Oddi creates favourable conditions for x-rays of the gallbladder (see also Atseklidin, Metoclopramide).

     Assign morphine under the skin (usually adults and 1 ml of 1% solution), the interior (0,01 - 0,02 g powders or drops). Children older than 2 years are designated according to the age of 0,001 - 0,005 grams at the reception. Children under the age of 2 years morphine is not appointed.

     When using morphine possible nausea, vomiting, respiratory depression and other side effects associated with the features of its impact on different organ system (see earlier). To reduce the side effects often designate with morphine atropine, metacin or other holinolitiki.

     Higher doses for adults (inside and under the skin) : single 0.02 grams daily 0.05 g.

     In recent years, in patients with acute and chronic pain became appoint morphine (and other opiates) epiduralno. Enter (if necessary with the introduction of this kind of precautions) 0.2 - 0.3 - 0.5 ml of 1% solution of morphine in 10 ml isotonic sodium chloride solution. The effect is manifested through 10 - 15 minutes; 1 to 2 h expressed a strong painkiller effect, which had lasted for 8 to 12 hours or more.

     While the application analgezii epidural morphine in patients with acute heart attack. Originally introduced 4 mg of morphine in 8 ml isotonic sodium chloride solution, then 2, 5 mg of morphine in 8 ml isotonic solution within 7 days. Observed clinical improvement and control zone necrosis.

     Morphine is not suitable for a strong overall depletion, lack of respiratory centre.

     Caution is necessary in the application of morphine in patients with age (slowed down and the exchange of morphine; There is a high morfnna in plasma).

     Method of production : tablets of 0.01 g; 1% solution in capsules and liquid pumps for 1 ml.

     Storage : List A. In the dark places with the storage of drugs.

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