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Morphine biliary pain

For the relief of pain arising from spasm of smooth muscle, as in renal or biliary colic, morphine is frequently employed. Other measures including antispasmodics such as atropine, atropine substitutes, theophylline, nitrites, and heat may be employed first however, if they are ineffective, meperidine, methadone, or opiates must be used. Morphine relieves pain only by a central action and may aggravate the condition producing the pain by exaggerating the smooth muscle spasm. Morphine may also be indispensable for the relief of pain due to acute vascular occlusion, whether this be peripheral, pulmonary, or coronary in origin. In painful acute pericarditis, pleurisy, and spontaneous pneumothorax, morphine is likewise indicated. Carefully chosen and properly spaced doses of codeine or morphine may occasionally be necessary in pneumonia to control pain, dyspnea, and restlessness. Traumatic pain arising from fractures, bums, etc., frequently requires morphine. In shock, whether due to trauma, poisons, or other causes, morphine may be required to relieve severe pain. [Pg.457]

Morphine has been reported to cause biliary pain by cansing contraction of the sphincter of Oddi and the lower common bile duct. Other opioids may be preferred over morphine in patients with biliary pain or where biliary tract spasm is undesirable [2]. [Pg.136]

As for all opioids common adverse effects are constipation, slowed gastric emptying and biliary spasm. Urinary retention may occur. There is an increased risk of respiratory depression in young children and in the elderly. Allergic reactions are rare, but wheals and pain at the injection site due to histamine release may occur. CNS depressants will potentiate the depressant effects of morphine and that of other opioids. [Pg.437]

Morphine can reduce biliary secretions, and patients with biliary colic may experience an exacerbation of pain after morphine. Similarly, opioids such as morphine can cause bile duct spasm [27]. Opioid-induced spasm of the sphincter of Oddi and increased intrabiliary pressure may result in a secondary increase in LFTs [55]. [Pg.193]

Pain due to spasm of visceral smooth muscle, e.g. biliary, renal colic, when severe, requires a substantial dose of morphine, pethidine or buprenorphine. These drugs themselves cause spasm of visceral smooth muscle and so have a simultaneous action tending to increase the pain. Phenazocine and buprenorphine are less liable to cause spasm. An antimuscarinic drug such as atropine or hyoscine may be given simultaneously to antagonise this effect. [Pg.325]

Therapeutic doses of opioids constrict the sphincter of Oddi, and biliary tract pressure rises ten-fold. Patients with biliary colic can have exacerbation of pain after morphine. Likewise, opioids such as fentanyl, morphine, and dextropropoxjrphene can cause bile duct spasm (SEDA-21, 85). [Pg.2624]

For drugs that have poor oral bioavailability, rectal administration of prodrugs can increase their absorption. For example, nalbuphine is an analgesic with potency approximately 0.5-0.9 that of morphine. It is used for the relief of moderate to severe pain from a variety of causes, e.g., surgery, trauma, cancer, kidney, or biliary colic pain. Oral bioavailability of nalbuphine was poor, e.g., around 6% in experimental dogs. Rectal administration of nalbuphine-3-acetylsalicylate in the same animals enhanced the bioavailability 4- to 5-fold to around 28%. In addition, the plasma half-life of nalbuphine after rectal administration of the prodrug was prolonged. [Pg.310]

Answer C. Morphine continues to be used in pulmonary congestion, in part because of its sedative (calming) and analgesic effects and also because of its vasodilating actions, which result in favorable hemodynamics in terms of cardiac and pulmonary function. Similarly, morphine is of value in an acute MI, especially its ability to relieve pain. However, morphine is not suitable for pain of biliary origin because it causes contraction of the sphincters of Oddi, leading to spasms. None of the other proposed indications are appropriate. [Pg.182]

The relief of pain by morphine-like opioids is relatively selective, in that other sensory modalities are not affected. Patients frequently report that the pain is still present, but they feel more comfortable. Continuous dull pain is relieved more effectively than sharp intermittent pain, but sufficient amounts of opioid can relieve even the severe pain associated with renal or biliary colic. [Pg.353]

UNTOWARD EFFECTS AND PRECAUTIONS Morphine and related opioids produce a wide spectrum of unwanted effects, including respiratory depression, nausea, vomiting, dizziness, mental clouding, dysphoria, pruritus, constipation, increased pressure in the biliary tract, urinary retention, hypotension, and rarely dehiium. Increased sensitivity to pain after analgesia has worn off also may occur. [Pg.358]


See other pages where Morphine biliary pain is mentioned: [Pg.406]    [Pg.78]    [Pg.27]    [Pg.437]    [Pg.319]    [Pg.452]    [Pg.456]    [Pg.456]    [Pg.78]    [Pg.744]    [Pg.750]    [Pg.269]    [Pg.389]    [Pg.470]    [Pg.316]    [Pg.167]    [Pg.82]    [Pg.44]   
See also in sourсe #XX -- [ Pg.136 ]




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Morphine, pain

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