Morphine sulfate

Gross

C34-H38-N2-O6.H2SO4

Characteristics

White crystals or crystalline powder, slightly jelteti temneuschi and storage. Rat in the water, poorly soluble in alcohol. Incompatible with alkalis. Aqueous solutions stabilize v. 0.1. HCl solution to pH 3.0-3.5.

Of drugs

The drugs-analgezirutee (drug). Waismann institute CNS receptors (delta-, mu- and kappa-), reduces anxiety and pain kashlevykh centers : protivosokowoe has operated from injuries. The hypnotic effect, euphoria, the activation stray nerves and the emergence bradikardii. Ingibiruet conditional reflexes, decreased ability summatinuyu CNS, the potenziruet deprimiruth funds. It stimulates the neurons glazodwigationah nerves, narrow tail (coma). Can initiate chemoreceptor trigger zone oblong brain and induced vomiting (some patients oppressing emetic Centre). Increases tone smooth muscles of internal organs : sfinkterov Oddi, bladder antralna part of the stomach, intestines, a pun, bronchus. Ters irritative, slows the movement of food masses contributes to the development of constipation. It stops the secretion of stomach, stimulates the antidiuretic hormone and reduces mocheotdelenie. Reduces the exchange and body temperature. Oppressing breathing Centre : small doses urejaut and increase the depth of breathing movements, the big to exacerbate ischemia and make breathing less deep by reducing lung ventilation; Toxic dose inducyruut periodic breathing type Chein-Stokes and the subsequent stop Dahania.bystro absorbed in the blood system, the oral or Injecting introduction, have low bioavailability (metabolised in the "first pass" through the liver). Most of the doses from kongugiruetsa glukuronova acid in the liver and gut, forming morfin-3-glukuronid inactive and active morfin-6-glukuronid; Remain active and biotransformation products (normorfin, codeine and complex broadcast morphine and sulphuric acid). In blood, about 35% due to the protein. Penetrates through gistogematicalkie barriers. Distributed throughout the body, mostly in the kidneys, liver, lungs and spleen, less in the brain and muscles. Defined in the spinal fluid (including in the form of active morfin-6-glukuronida) platzente, milk. Average T_1/2 1.7 h for morphine and 2,4-6,7 hours for morfina-3-glukuronida. About 10% of the excreted jelchew and faeces, the rest with urine in the form of kongugatov. Over 24 hours is 90% dose sledove amount determined in the urine after 48 C.actie develops in 10-15 min w / to the injections and after 20-30 min after administration inwards and continues 3-5 pm

Indications

The pain, intensive chronic non kupiruemaya analgetikami others (such as in oncology), premedikation, insomnia caused severe pain expressed cough, shortness of breath and acute heart failure; X-ray study of the stomach, duodenal ulcer and gall bladder (increases tone stomach, increases its irritative, accelerates emptying and strength of duodenal ulcer contrasting substance).

Contraindications

CHD deficiency, abdominalnaya pain unclear etiology, severe liver failure, trauma to the brain, or intracranial hypertension, epileptic status, acute alcohol intoxication, deliri, child age (2.5 years).

Side-Effects

Nausea, vomiting, constipation, diarrhea, holetaz whose urine, respiratory depression, hallucinations, deliri, raising vnutricerepnogo pressure, physical and mental dependence (after 1-2 weeks regular admission), the syndrome of "lifting" : Yawn, midriaz, slezotechenie, allocation from the nose, sneezing, muscle apnoea, headache, fatigue, sweating, anxiety, irritability, insomnia, anorexia, lower body mass index, dehydration, pain in the extremities, and abdominal muscle cramp, tachycardia, unevenly respiration, hyperthermia, hypertension.

Patient interaction

Incompatible with MAO inhibitors.

Overdosing

Many expressed side Protemenami.lechenie : maintaining vital functions, the introduction of specific antagonists (naloxone, nalorfin, levalorfan).

Dosing and Administration

The inside is not liquid, and 1 caps. (10-100 mg) twice a day, every 12 hours Dose individually vary, depending on the severity of pain and pain effect.

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