How to use the powerful morphine correctly?

Knowledge cards

The use of narcotic drugs and psychotropic substances is dual. If it is used improperly, it will cause harm to the society and the people. At the same time, it will also cause adverse effects on medical institutions. Strengthening the management of the use of narcotic drugs and psychotropic substances and strengthening the publicity and guidance of correct use is of great importance to the correct understanding, rational use, and knowledge and compliance of medical personnel and patients.

How to use the powerful morphine correctly?

Morphine is an opioid receptor agonist that produces a powerful analgesic effect by exciting opioid receptors within the central nervous system.

【Indications】

1． Potent analgesia: Although effective for all pain, it is clinically severely limited. The first is for acute severe pain that is ineffective with other analgesics, such as surgery, trauma, severe pain of burns, and short-term use. The second is severe pain for patients with advanced cancer, which is a representative drug.

2． Myocardial infarction: used in patients with normal blood pressure myocardial infarction, which has the effect of calming and reducing the workload of the heart and relieving fear.

3． Cardiogenic asthma: temporary relief of symptoms of pulmonary edema.

4． Anesthesia and preoperative administration: quiet the patient and enter a state of drowsiness.

【Application Principle】

1． It must be strictly managed in accordance with the relevant provisions of the state and used strictly according to the indications.

2． Do not use this drug until the cause of the pain is clear, so as not to mask the symptoms and delay the diagnosis.

3． For patients with advanced cancer with severe pain, according to the World Health Organization's three-step analgesia principle, oral administration, on time, on demand, and dose is individualized, generally does not cause addiction.

4. Extended-release tablets are only used for analgesia in patients with advanced cancer.

5． Overdose can lead to acute poisoning, long-term use of morphine can lead to tolerance, and for patients with severe cancer pain for long-term chronic medication, the dosage can be gradually increased from low doses.

【How to use】

Oral administration, intravenous injection, epidural injection, subarachnoid injection.

【Contraindicated people】

Hypersensitivity to this or other opioids; pregnant, lactating, newborn, and infant; shock uncontrolled; toxic diarrhea; inflammatory ileus; hypoventilation, respiratory depression; bronchial asthma; chronic obstructive pulmonary disease; decompensation of pulmonary heart disease; intracranial hypertension or head injury; hypothyroidism; adrenal insufficiency; hypertrophy of the prostate, difficulty urinating; severe hepatic insufficiency.

【Adverse reactions】

1． Cardiovascular system: peripheral blood vessels may be dilated, resulting in orthostatic hypotension. Intrathecal and epidural administration can lead to a decrease in blood pressure.

2． Respiratory system: direct suppression of the respiratory center, suppression of cough reflex, severe respiratory depression can lead to respiratory arrest, occasionally bronchospasm and laryngeal edema.

3． Bowel: nausea, vomiting, constipation, abdominal discomfort, abdominal pain, biliary colic.

4． Urinary system: oliguria, urinary frequency, urgency, dysuria, urinary retention.

5． Nervous system: transient haze, drowsiness, distraction, decreased mental capacity, apathy, depression, restlessness, panic, fear, vision loss, blurred or diplopia, delusions, hallucinations.

6． Endocrine system: long-term medication can cause the degradation of secondary sex characteristics in men, amenorrhea in women, and lactation inhibition.

7． Eye: The pupil is constricted like a needle tip.

8． Skin: urticaria, itching and skin edema.

9． Withdrawal reactions: i.e., physical dependence, abrupt discontinuation or administration of opioid antagonists may result in withdrawal syndrome manifested by lacrimation, runny nose, sweating, dilated pupils, increased blood pressure, increased heart rate, increased body temperature, vomiting, abdominal pain, diarrhea, muscle and joint pain and increased nervousness, increased mental excitability, manifested by panic, restlessness, yawning, tremor, and insomnia.

Source: Dongzhimen Hospital, Beijing University of Chinese Medicine Author: Xue Chunmiao