Tuesday, September 1, 2015



Morphine , sold under many trade names,is a pain medication of the opiate type. In Nepal its been manufactured and marketed by National Healthcare Pvt. Ltd as trade name under MORFIUM.

Its one of the best selling product from National Healthcare Nepal.

It acts directly on the central nervous system (CNS) to decrease the feeling of pain. It can be used for both acute pain and chronic pain.

 Morphine is also frequently used for pain from myocardial infarction and during labour

It can be used orally, intramuscularly (IM), subcutaneously, intravenously(IV), into the space around the spinal cord, or rectally.

 Effectivenes : Maximum effect is around 20 min when given intravenously and 60 min when given by mouth while duration of effect is between three and seven hours.

Long acting formulations also exist. 

Sources, street names :

Morphine is obtained from the seedpod extract or opium found in the poppy plant, Papaver somniferum.

Morphine is widely used in clinical pain management, especially for terminal cancer pain and post-surgery pain. In the body, morphine has several effects including reduction of pain, loss of hunger, and suppression of cough.
Some of the clinical uses of morphine include:
  • Pain relief after surgery
  • Pain relief after major trauma or injury except head injuries
  • Pain relief in advanced cancers with terminal cancer pain

Morphine legal status

Worldwide, morphine is a Schedule I drug under the Single Convention on Narcotic Drugs. In the Unites Sates, morphine is a Schedule II drug under the Controlled Substances Act and in the UK, it is a Class A drug under the Misuse of Drugs Act 1971 and a Schedule 2 controlled Drug under The Misuse of Drugs Regulations 2001. In Australia, it is classified as a Schedule 8 drug under State and Territory Poisons Acts.

Patient/Family Education

  Instruct patient to take oral preparations with food or juice if GI upset occurs.
  Tell patient not to crush or chew controlled-release tablets.
  Explain that full effectiveness of drug may not occur for 30 to 60 min after administration. Emphasize that drug is more effective if taken regularly to prevent pain rather than to treat pain after it occurs.
  If patient is to receive patient-controlled analgesia (PCA), instruct on use of PCA pump.
  Explain that physical dependency may occur with long-term therapy and that dosage will be tapered slowly before stopping to prevent withdrawal symptoms (nausea, vomiting, cramps, fever, faintness, anorexia).
  Encourage patient to turn, cough and breathe deeply every 2 h to prevent atelectasis.
  Advise patient to consult with health care provider if excessive sedation occurs or if pain relief is inadequate.
  Inform patient that drug may cause constipation. Stool softener, fiber laxative, increased fluid intake and bulk in diet may help alleviate problem.
  Caution patient to avoid sudden position changes to prevent orthostatic hypotension.
  Instruct patient to avoid intake of alcoholic beverages and other CNS depressants.
  Advise patient that drug may cause drowsiness, dizziness or blurred vision and to use caution while driving or performing other tasks requiring mental alertness.


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