Morphine dosing data

Yamaguchi H, Watanabe S, Motokawa K, Ishizawa Y. Intrathecal morphine dose-response data for pain rehef after cholecystectomy. Anesth Analg 1990 70(2) 168-71. 

Brain uptake data for some vectors are compared in Table 2.1. Quantitative comparisons within the same species are possible for the rat with vectors derived from the anti-TfR monoclonal antibody 0X26 and from cationized human serum albumin. To put the efficiency of brain delivery into perspective, the comparison to a classical neuroactive drug may be informative. In the rat, brain concentrations of morphine following systemic administration never exceed 0.08% of injected dose per gram [%ID g ] [82]. In contrast, 0X26 easily reaches concentrations in rat brain that are three to four times higher. Vectors based on cationized hu-... 

Small doses of trazodone (25 to 50 mg) at bedtime may be useful as a sedative-hypnotic. More data are required on pain control and analgesia using low-dose opioids on a short-term basis, which may also benefit anxiety. For example, the use of morphine in patients with advanced disease has been found to be particularly helpful in decreasing their associated anxiety. 

The following section describes the most important and widely used opioid analgesics, along with features peculiar to specific agents. Data about doses approximately equivalent to 10 mg of intramuscular morphine, oral versus parenteral efficacy, duration of analgesia, and intrinsic activity (maximum efficacy) are presented in Table 31-2. 

Interestingly, morphine is primarily considered to have selective effects on the mu opioid receptor for its analgesic effects however, there is also evidence that it possesses effects on delta or kappa opioid receptors and that crosstalk can occur between mu and delta opioid receptors [44]. To test the hypothesis that the cardioprotective effects of IPC and morphine were acting via a delta opioid receptor, Schultz et al. [45] administered the selective delta receptor antagonist naltrindole to rats prior to IPC or morphine infusion. In both instances, the cardioprotective effects of morphine and IPC were completely abolished at a dose of naltrindole that had no effect by itself on infarct size in nonpreconditioned rat hearts. These data clearly suggest that both IPC and morphine are exerting their cardioprotective effects via the delta opioid receptor in the intact rat heart. 

Development of morphine tolerance and physical dependence is markedly suppressed by the administration of NTI or its isothiocyanate analogue nal-trindole 5 -isothiocyanate (NTII, 116) before and during morphine treatment [180], These effects are produced by NTI and NTII at doses that do not block the antinociceptive effects due to interaction at fi receptors. These data are of interest from the standpoint of preventing tolerance and physical dependence in patients who receive morphine on a chronic basis [173]. NTI... 

In further studies by Piischel et al., codeine was administered to drug-free volunteers. Beard hair samples were collected and assayed by Abuscreen RIA. Codeine was detected within 24 h of drug administration and was present for a period of 6 to 8 d. Cone also studied the time course of appearance of morphine and codeine in beard hair following single dose administration of morphine and codeine in two human subjects. Data were obtained with the DPC morphine-specific RIA and GC/MS. Morphine and codeine appeared in beard hair about 7 to 8 d after... 

A dispensing system fitted with a counting mechanism also is available (Fig. 6). It allows the consumer to monitor each actuation, beginning from the first priming stroke until delivery of the last dose. A dispensing system for controlled substances, such as morphine, can be equipped with a lock-out system. The microchip controlled actuation mode takes into account the patient s specific requirements, such as amount of drug and frequency of administration. Other relevant data are recorded and can be evaluated later by a physician. 

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