Morphine

Morphine hydrochloride/ Fentanyl, Oxycodone, Ondine    
                   Classification: narcotic and opioid analgesic
                 Indications:relief of severe acute or chronic pain, properative medication,
                              component of combo therapy, intraspinal intractable pain.
                   Action: binds with opiate receptors in CNS, altering both perception of and
                           emotional response to pain through an unknown mechanism.
                          Produces analgesia, euphoria and sedation.

                   Adverse/side effects:

                    Light headedness, dizziness, psychoses, anxiety, fear, hallucinations

                   sedation, nausea, vomiting, 

                   dry mouth, respiratory depression, ureteral spasm

                     Constipation, apnoea, circulatory depression, shock, cardiac arrest.

                     Drug-drug
                              CNS depressants, barbiturate general anaesthetics, phenothiazines,
                               MAO inhibitors,
                                other narcotic analgesics, seatives, tranquillisers,
                                 tricyclic antidepressants.Alcohol- has an additive effect.

                   Contraindications
                               Hypersensitivity, obstructive airway disease, depleted respiratory
                                reserve conditions such as premie babies,alcoholism, DTs, HF,
                               cardiac arrhythmias,  head injury, raised intracranial pressure,
                               convulsive states, CNS depression, brain tumour,
                                liver or renal disease, individuals taking MAO inhibitors.
                                acute abdomen, ulcerative colitis,
                   Care considerations
                               Use extreme caution in hypothyroidism, cases of urinary stricture,
                                 elderly or debilitated.
                              Keep naloxalone available.
                               No crush, break or chew.
                               Drug of choice for MI pain.
                               Monitor circulatory, respiratory and bowel function.
                               Constipation may be severe with maintenance dosage.