Morphine, alias: morphine Hydrochlride, morphina, morphinum. Morphine is the most important alkaloid in opium (content about 10-15%), which was first isolated from opium by French chemist f. zeltina in 1806. He experimented with the separated white powder on the dog and himself. The results showed that the dog soon fell asleep after eating, and the strong stimulation method could not wake him up; He himself could not wake up after swallowing the powder. Accordingly, he named these substances “morphine” after Morpheus, the God of sleep in Greek mythology.
Pure morphine is colorless or white crystal or powder, insoluble in water and easy to absorb moisture. With the increase of impurity content, the color gradually deepened, and the crude morphine was a coffee like brown powder. In the “Golden Triangle” region, morphine base and crude morphine are also known as “yellow skin”, “yellow arsenic” and “No. 1 heroin”. In the illegal trade, the “yellow skin” is traded according to the number of “pieces”, each weighing 1kg. Illegally produced morphine is usually made into bricks. Southeast Asian products have trademarks such as “999”, “AAA” and “OK”, which are white, light yellow or brown. The nose smells sour, but it has a strong sweet smell when inhaled. Morphine abusers mostly use injection. Under the same quality, the effect of morphine injection is 10-20 times stronger than that of opium.
Medical morphine is generally the sulfate, hydrochloride or tartrate of morphine, which is easily soluble in water. It is often made into small white tablets or into injections after dissolving in water. Its pharmacological effects include:
(1) Effect on central nervous system: strong anesthetic and analgesic effects. The anesthetic and analgesic effects of morphine are unmatched by any natural compound. It has a wide range of analgesia, and is almost applicable to all kinds of severe pain, including severe pain of advanced cancer. The analgesic time of one administration can reach 4-5 hours, and it can keep consciousness and other feelings unaffected during analgesia. In addition, it has obvious sedative effect, which can eliminate the emotional reactions such as anxiety, tension and fear caused by pain, and significantly improve the patient’s tolerance to pain. The analgesic sites of morphine are the nerve structures around the third ventricle, from the tail end of the third ventricle to the head end of the fourth ventricle and the periaqueductal gray matter.
(2) Effect on respiratory system: morphine can inhibit the activities of brain respiratory center and cough center, slow down breathing and suppress cough. Acute poisoning can lead to paralysis of respiratory center, respiratory arrest and death.
(3) Effect on cardiovascular system: the therapeutic dose of morphine has no significant effect on blood vessels and heart rate. High dose of morphine can cause postural hypotension and bradycardia.
(4) Effect on digestive system: it can stimulate gastrointestinal smooth muscle and sphincter, increase its tension and weaken its peristalsis. Therefore, it has the effect of stopping diarrhea and treating constipation.
The side effects of morphine on the nerve center are drowsiness and personality changes, which cause a certain degree of comfort and pleasure; In the cerebral cortex, it can cause the decline of adult attention, thinking and memory performance. The long-term use of large doses of morphine will affect the symptoms of mental disorders, death and hallucinations; In the respiratory system, large doses of morphine can lead to respiratory arrest and death. The extremely addictive nature of morphine makes long-term smokers have a serious dependence on morphine both physically and psychologically, resulting in serious toxicosis, so that morphine addicts continue to increase the dose to achieve the same effect.
Withdrawal symptoms of morphine include sweating, trembling, fever, high blood pressure, muscle pain and contracture.
1. Analgesia: it has a strong analgesic effect and is effective for all pain. It has a stronger effect on persistent dull pain than intermittent sharp pain and visceral colic. Once administration, the analgesic effect lasts for 4 ~ 8 hours, so it is only used for severe pain caused by trauma, operation, burn and myocardial infarction.
2. Sedation: it has obvious sedative effect while analgesia, and sometimes produces euphoria, which can improve the tension of patients with pain.
3. Respiratory inhibition: it can inhibit the respiratory center and reduce the sensitivity of the respiratory center to carbon dioxide.
4. Antitussive: it can inhibit cough center and produce antitussive effect. Because of addiction, it is not suitable for clinical use.
5. Effect on smooth muscle: it can excite the smooth muscle of digestive tract and cause constipation; It also increased the tension of smooth muscle of biliary tract, ureter and bronchus.
6. Cardiovascular system: it can promote the release of endogenous histamine and dilate peripheral blood vessels and reduce blood pressure; Make cerebral blood vessels dilate and cranial pressure increase.
7. Antiemetic: it is also not suitable for clinical treatment because of addiction.
[function and use]It has analgesic, sedative, antitussive, respiratory and intestinal peristalsis effects. For severe pain and administration before anesthesia.
1,Continuous use is addictive and should be used with caution.
2. It should not be used by infants and lactating women, and should not be used by parturient women (because it can be discharged and distributed to the placenta through the mammary gland, it can inhibit the respiration of newborns and infants).
3. It can cause adverse reactions such as dizziness, vomiting and constipation.
4. Chronic obstructive pulmonary disease, bronchial asthma and pulmonary heart disease are prohibited; Do not use it in the late stage of acute left heart failure with respiratory failure.
5. It is forbidden for patients with intracranial hypertension and craniocerebral injury.
6. It should not be used in patients with decreased liver function.
7. Biliary colic and renal colic need to be combined with atropine. Using this product alone will aggravate the pain.
8. Do not use this product until the cause of pain is clear, so as not to cover up symptoms and delay diagnosis and treatment.
9. The degree of respiratory inhibition is parallel to the dose of morphine. Excessive dose can cause patients with acute morphine poisoning to fall asleep, slow breathing, narrow pupil and needle tip, and then cause respiratory paralysis and death