Morphine poisoning

In a study of chronic morphine poisoning in dogs, wide variability was noted not only with respect to the direct effects of the alkaloid but also the effects observed when it was withdrawn after a period of months.24 The variability in the initial response of dogs to morphine is illustrated in another study25 in which one dog (No. 15) showed pupillary contraction (8 to 5 mm), a slight decrease in pulse rate (130 to 108), and a marked decrease in respiration rate (150 to 40). Another dog (No. 20) showed no contraction of the pupil (6 to 6 mm), a marked decrease in pulse rate (120 to 50), and a marked increase in respiration rate (42 to 96). Still another dog (No. 45) showed slight pupillary expansion (7 to 8 mm ), decrease in pulse rate (138 to 96), and over a 4-fold increase in respiration rate (43 to 180). 

Sodium permanganate (NaMnO ) is a purple crystal that is soluble in water and is used as an oxidizing agent, disinfectant, and bactericide and as an antidote for morphine poisoning. 

For the treatment of poisoning, a selective antidote (which antagonises the action) may be given e.g., nalorphine and naloxone in case of morphine poisoning, atropine in case of anticholinergic drugs, dimercaprol in mercury and penicillamine in lead poisoning, etc. 

It is inactive orally because of high first pass metabolism in liver. Metabolised by glucuronidation in liver. The main use of naloxone is in the treatment of acute opioid overdose (acute morphine poisoning). It also precipitates withdrawal syndrome when administered to morphine addicts. The constricted pupils of addicts dilate after administration of naloxone. This has been used as a diagnostic tool for opioid addiction. 

Caffeine (40 R1 = R2 = R3 = Me) is a powerful CNS stimulant, and the other xanthines theophylline and theobromine have rather less activity. The popularity of beverages containing xanthines depends on this stimulant effect. Caffeine is useful in morphine poisoning. 

Koren G, Cairns J, Chitayat D, Gaedigk A, Leeder SJ (2006) Pharmacogenetics of morphine poisoning in a breastfed neonate of a codeine-prescribed mother. Lancet 368(9536) 704... 

Although methadone is used for the management of opioid dependence, symptoms of overdose are similar to those of morphine poisoning. 

Nalorphine (11 N-allylnormorphine Fig. 11.4) [31] was found to antagonize the properties of morphine, and was utilized as an antidote for morphine poisoning,... 

Morphine is the constituent of opium most responsible for its toxic effects. When taken orally, the effects of morphine poisoning begin to appear in 20-40 minutes if taken hypodermically, the symptoms appear much earlier and narcotism is more likely to follow the early symptoms. Abuse leads to habituation or addiction. Individual susceptibility varies greatly and children are more susceptible than adults. When heated to decomposition it emits toxic fumes of NOx. 

Severe morphine poisoning may result in respiratory failure after fainting fits, accompanied by coma and acute miosis. It exerts effects on the gastrointestinal tract, decreasing the spasmotic reflexes in the intestinal tract, thus resulting in constipation. 

His undoing was a conversation reported by a witness. The doctor, it seems, had railed against another accused morphine poisoner, calling him an incompetent. That poisoner had been undone by the fact that his victim had pinpoint pupils, and Buchanan had declared the fellow a fool for neglecting to apply belladonna. When this story surfaced, another witness recalled Dr. Buchanan putting drops in his wife s eyes before she died. The good doctor was executed in the same electric chair in which the bungler had met his end two years earlier. 

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