Morphine was isolated in 1804 by German pharmacist Friedrich Wilhelm Adam Sertürner. However, morphine has not been used to develop a hypodermic needle (1853). Morphine is used to relieve pain and as a cure for alcohol and opium addiction.
Although morphine can be made synthetically, but it is easier and commercially viable, which is made of resin materials somniferum. Morphine more easily soluble in water than other opiates and analgesinya work long enough (long-acting). (Latief et al, 2001; Sarjono et al, 1995).
employment effects of morphine (and opioids in general) relatif selective, ie, does not really affect other sensory elements, namely a sense of self, a sense of vibration (vibration), vision and hearing, bahakan nyeripun perception does not always disappear after administration of therapeutic doses of morphine.
The analgesic effects of morphine is based on three mechanisms: (1) morphine raise the threshold for pain stimuli, (2) morphine may mempengaharui emotion, which means that morphine may modify the reactions that occur in the cerebral cortex during the perception of pain is received by the cerebral cortex of the thalamus, (3) morphine facilitate sleep and sleep time increased stimulation threshold of pain.
Morphine is an opioid receptor agonist, with the main effect of binding and activation of μ-opioid receptors in the central nervous system. receptor activation is associated with analgesia, sedation, euphoria, physical dependence and respiratory depression. Morphine acts as an agonist at κ-opioid receptors involved in spinal analgesia and miosis
Figure morphine (powder) Structure Figure morphine
Pharmacodynamics
Effects of morphine occurs in the central nervous system and organs containing smooth muscle. Effect of morphine in the central nervous system has two properties namely depression and stimulation. Depression is classified as analgesia, sedation, changes in emotions, alveolar hypoventilation. For example, the stimulation of parasympathetic stimulation, miosis, nausea, vomiting, hyperactive spinal reflexes, seizures, and the secretion of antidiuretic hormone (ADH). . (Latief et al, 2001; Sarjono et al, 1995 and Wibowo Gopura S A. 1995; Omorgui, 1997).
Pharmacokinetic
Morphine can not penetrate intact skin, but can reach the skin wounds. Morphine can also penetrate the mucosa. Morphine can diabsorsi intestine, but the analgesic effect after oral administration is much weaker than the analgesic effects that may occur after parenteral administration of the same dose. Morphine can pass the placental barrier and affect the fetus. Morphine primarily by renal excretion. A small free morphine found in feces and sweat.
Indication
Morphine and other opiates initially identified to mitigate or eliminate the pain can be treated with opioid analgesics. More serious is the pain of the dose of the growing need. Morphine is often necessary for the pain that accompanies it, (a) myocardial infarction, (2) Tumors (3) and biliary colic, renal colic (4), acute peripheral vascular occlusion, pulmonary or coronary artery, (5) Acute pericarditis pleurisy and spontaneous pneumotorak, (6) pain due to trauma such as burns, fractures and post-surgical pain.
The dose and dose
Morphine is available in tablets, injections, suppositories. Morphine oral solution is administered regularly every four hours. Recommended dosage to eliminate or reduce pain was 0.1 to 0.2 mg / kg of body weight. For severe pain in adults, 1-2 mg intravenously Yamgan can be repeated as necessary.
Morphine traded freely on the form:
Powder or dust. White and easily soluble in water. Can be misused by injection, snuff, or mixed drinks, sometimes just sprinkled on the wounds disilet even by the victims.
White liquid stored in jars or bottles, its use is only by injecting the road.
Balokan. Created in small blocks of different sizes and colors
Tablets. Created in the form of small white pills. Morphine is well absorbed after administration of subcutaneous (under the skin) or intramuscular, but not well absorbed from the gastrointestinal tract. Thus, morphine is not available in the form of drug use. subjective effects experienced by individual users of morphine, among others, to feel happy, relaxed, sleepy, and sometimes ends in a pleasant dream. morphine users generally considered apathy, decreased ability to concentrate, and often interrupted his mind at the time did not use morphine. These effects cause users to feel an addiction. In addition to clinical services, morphine may be a risk of side effects are varied, including systematic effects on the respiratory, gastrointestinal, urinary and systematic. systematic effects on the respiratory form of respiratory depression, which is often fatal and death. These effects usually occur shortly after intravenous administration or approximately one hour after intramuscular injection. This effect is greater in patients with asthma, since morphine also resulted in the emergence of a narrowing of the airways. systematic effects in the gastrointestinal tract usually in the form of constipation, which is due to morphine can improve muscle tone and motility of the lower gastrointestinal tract. Morphine in urine can cause difficulty urinating. This effect is due to the fact that morphine can reduce the perception of stimuli cause the contraction of the ureter and urinary tract and bladder muscles. The signs of drug use varies by type of drug, the quantity used and sipemakai personality and expectations.
Symptoms of overdose:
students from very small (identify) one to one breath and coma (three classic symptoms). When they are very serious, can cause dilatation (dilated pupils). As is often accompanied by nausea (nausea). Sometimes the resulting pulmonary edema (lung wet). Symptoms of drugs: restlessness, muscle and bone pain, insomnia, headaches. If the use is very (very high doses) can cause convulsions (fits) and coma, tears (lakrimasi) out of the water through the nose (rhinorhea), profuse sweating, cold turkey, dilated pupils, increased blood pressure, rapid pulse, hyperpyrexia (body temperature rises), agitation and anxiety, tremors, sometimes toxic psychosis.
The diagnosis of drug addiction
The diagnosis of patients with opioid dependence is established by clinical examination (medical / psychiatric) and supported by a urine test. Opiates in drug abuse, often met with medical complications such as organ defects in the lungs and liver. Drug addiction is a pattern of substance use disorders is at least a one month period. Opioids, including a man who often abused. ICD 10 (International Classification of Diseases), a variety of mental and behavioral disorders due to substance use are classified in various clinical conditions such as acute intoxication, dependence syndrome, the syndrome is the end and other mental and behavioral disorders .
The drug withdrawal is a set of clinical symptoms occur after stopping or reducing the dose of the drug substance is persistent previously used. final status of the heroin is not as dangerous. Among teens called “Sakau” and overcome a heroin addict trying to obtain, even by harming others as a criminal act. The symptoms of opiate final objective, ie nausea / vomiting, muscle aches lakrimasi, Rinorea, dilated pupils, diarrhea, yawning / sneezing, fever and insomnia. To overcome this obstacle, because the symptoms. For example, to reduce the pain may be analgesic to relieve vomiting antiemetik given, and so on. ‘S base of treatment for the syndrome of opioid treatment programs must be followed by detoxification and maintenance therapy. In overdose deaths caused medical complications such as respiratory problems, namely, acute pulmonary edema (banks and Waller). Meanwhile, McDonald (1984) study indicated that drug use was a strong link with death and disability caused by accidents, suicide and murder.
Drug abuse is very diverse, but the most widely used drug has its place in the main action of central nervous system and can cause disturbances in perception, feelings, thoughts and behavior and movement of muscles people use ynag. Violence in the overall objective is to achieve change in a moment of mental excitement. calming effect is often used to overcome anxiety, frustration, anxiety, impulses that are too excessive mental weakness or immature personality. Although the stimulating effect is often used to launch a partnership, or a task, increase sexual arousal, improve endurance. Drug abuse can be seen from the following:
signs of drug
drug-free state
Acute Overdose
medical complications (complications kedoktearn)
other complications (social, legal, etc)
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