Morphine - description of the drug, instructions for use, reviews

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Manufacturers: Moscow Endocrine Plant

Active ingredients

• Morphine

Disease class

• Heart failure
• Pain in the heart area
• Constant, unrelieved pain
• Surgical practice

Clinical and pharmacological group

• Not indicated. See instructions

Pharmacological action

• Analgesic (narcotic)

Pharmacological group

• Opioid narcotic analgesics

Morphine injection solution

Instructions for medical use of the drug

Description of pharmacological action

Stimulates opiate receptors.

Indications for use

Severe pain syndrome (trauma, malignant neoplasms, myocardial infarction, in the postoperative period, etc.), preparation for surgery, insomnia associated with severe pain, cough, severe shortness of breath in acute cardiovascular failure.

Release form

1 ampoule with 1 ml of solution for injection contains morphine hydrochloride 0.01 g; per pack 5 pcs. solution for subcutaneous administration 10 mg/ml; syringe tube 1 ml, box (box) 100;

Pharmacodynamics

Stimulates mu, delta and kappa subtypes of opioid receptors. Inhibits the interneuronal transmission of pain impulses in the central part of the afferent pathway, reduces the emotional assessment of pain, the reaction to it, causes euphoria (mood improves, there is a feeling of mental comfort, complacency and bright prospects, regardless of the real state of affairs), which contributes to the formation of dependence (mental and physical). Reduces the excitability of the thermoregulation center, stimulates the release of vasopressin. It has virtually no effect on vascular tone. In high doses, it exhibits sedative activity, depresses the respiratory, cough and, as a rule, vomiting centers, stimulates the centers of the oculomotor (miosis) and vagus (bradycardia) nerves. Increases the tone of the smooth muscles of the gastrointestinal sphincters with a simultaneous decrease in peristalsis (locking effect). May stimulate the chemoreceptors of the vomiting center trigger zone and cause nausea and vomiting. The effect on mu receptors is associated with supraspinal analgesia, euphoria, physical dependence, respiratory depression, and stimulation of the vagus nerve centers. Stimulation of kappa receptors causes spinal analgesia, sedation, and miosis. Excitation of delta receptors causes analgesia.

Pharmacokinetics

It is quickly absorbed into the blood by any route of administration (orally, subcutaneously and intramuscularly). Easily passes barriers, incl. BBB, placental (can cause depression of the respiratory center in the fetus and therefore is not used for pain relief during labor). Metabolized, forming mainly glucuronides and sulfates. Excreted by the kidneys. Small amounts are secreted by all exocrine glands. The analgesic effect develops 5–15 minutes after subcutaneous and intramuscular administration, after oral administration - after 20–30 minutes and usually lasts 4–5 hours.

Use during pregnancy

During pregnancy and during breastfeeding, use is permissible only for health reasons (respiratory depression and the development of drug dependence in the fetus and newborn are possible).

Contraindications for use

General severe exhaustion, respiratory failure, childhood (up to 2 years).

Side effects

Nausea, vomiting, respiratory depression; pronounced euphoria, drug dependence.

Directions for use and doses

SC, IM or IV. The dosage regimen is individual, doses depend on the indications, route of administration, and patient's condition. The highest daily dose for adults is 50 mg (except for incurable cancer patients, in whom it can reach 1 g/day). Frequency of administration: every 12 hours.

Overdose

Symptoms of acute and chronic overdose: cold clammy sweat, confusion, dizziness, drowsiness, decreased blood pressure, nervousness, fatigue, miosis, bradycardia, severe weakness, slow difficulty breathing, hypothermia, anxiety, dry oral mucosa, delirious psychosis, intracranial hypertension (up to cerebrovascular accident), hallucinations, muscle rigidity, convulsions, in severe cases - loss of consciousness, respiratory arrest, coma. Treatment: resuscitation measures, intravenous administration of a specific antagonist of opioid analgesics - naloxone.

Interactions with other drugs

Extends and enhances the effect of drugs that depress the activity of the central nervous system, incl. sleeping pills, sedatives, drugs for general anesthesia, anxiolytics, neuroleptics and local anesthetics. Drugs that depress the central nervous system, incl. ethanol, enhance the depressive effect and respiratory depression (muscle relaxants also act). With systematic use of barbiturates, especially phenobarbital, there is a possibility of a decrease in the severity of the analgesic effect. Caution should be used simultaneously with MAO inhibitors due to possible overexcitation or inhibition with the occurrence of hyper- or hypotensive crises (initially, to assess the effect of interaction, the dose should be reduced to 1/4 of the recommended). When taken simultaneously with beta-blockers, it is possible to increase the inhibitory effect on the central nervous system, with dopamine - a decrease in the analgesic effect of morphine, with cimetidine - increased respiratory depression, with other opioid analgesics - increased depression of the central nervous system, respiration, hypotension. Chlorpromazine enhances the sedative and analgesic effects of morphine. Phenothiazine derivatives and barbiturates enhance the hypotensive effect and increase the risk of respiratory depression. Naloxone reduces the effect of opioid analgesics, as well as the respiratory and central nervous system depression they cause. Nalorphine reverses the respiratory depression caused by morphine. Strengthens the hypotensive effect of drugs that lower blood pressure (including ganglion blockers, diuretics). Competitively inhibits the hepatic metabolism of zidovudine and reduces its clearance (increases the risk of mutual intoxication). Drugs with anticholinergic activity, antidiarrheal drugs (including loperamide) increase the risk of constipation, including intestinal obstruction, urinary retention and central nervous system depression. Reduces the effect of metoclopramide. Morphine may increase the anticoagulant activity of coumarin and other anticoagulants.

Precautions for use

Morphine should not be used in situations where paralytic ileus may occur. If there is a risk of paralytic ileus, the use of morphine should be discontinued immediately. In patients undergoing cardiac surgery or other surgery with intense pain, the use of morphine should be discontinued 24 hours before surgery. If therapy is subsequently indicated, the dosage regimen is selected taking into account the severity of the operation. If nausea and vomiting occur, a combination with a phenothiazine can be used. During the treatment period, care must be taken when driving vehicles and engaging in other potentially hazardous activities that require increased concentration of attention and speed of psychomotor reactions, and avoid the use of ethanol. The simultaneous use of other drugs acting on the central nervous system (antihistamines, hypnotics, psychotropic drugs, other painkillers) is allowed only with the permission and under the supervision of a physician. It should be kept in mind that children under 2 years of age are more sensitive to the effects of opioid analgesics and may experience paradoxical reactions.

Storage conditions

List A: In a place protected from light, at a temperature not exceeding 20 °C.

Best before date

24 months

ATX classification:

N Nervous system

N02 Analgesics

N02A Opioids

N02AA Opium alkaloids natural

N02AA01 Morphine

How much do drugs cost and where are the most drug addicts in Russia?

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The use of the substances listed below is prohibited in Russia and can cause irreparable harm to health. Information is provided for research purposes only.

Around mid-July, the largest trading platform in the Russian part of the darknet, RAMP (Russian Anonymous Marketplace), appears to have been closed.

This is a market specializing in drugs. Other beloved product categories, such as guns, child porn, fake passports and contract killings, were not sold on RAMP. Now there are rumors that the site was closed by the GUKON Ministry of Internal Affairs, the FSB or someone else. True, the site has mirrors and instant trading platforms.

It's time to estimate what volumes of sales of substances we could be talking about. A total of 14,000 buyers and sellers were registered on RAMP. This, of course, is not the whole underwater part of the iceberg: there are at least bots and secret chats in Telegram. But this figure can give some idea of ​​the black market. Moreover, I just found a suitable article, which contains data on the number of dealers and the cost of drugs in different cities of Russia. The authors of the article were able to obtain them by analyzing the RAMP site using program code. The results are interesting)

01. Firstly, the most “drug addict” cities. It is known that demand creates supply, so the cut is quite clear. It is also necessary, of course, to take into account the availability of supplies and the prevalence of the darknet as a trading platform in each specific city. It turns out that the most popular cities among RAMP sellers and buyers are Moscow, St. Petersburg, Yekaterinburg and Tomsk. It is strange that Tomsk is ahead of, for example, Novosibirsk in this list. I think it has to do with dealers' awareness of the existence of RAMP.

There is also a graph with average drug prices. The spread is very large. You will see later in the post that prices for different types of psychoactive substances vary greatly from city to city. And in some cases it is not at all clear how the price is formed.

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02. Number of dealers of all drugs in different cities. Moscow, St. Petersburg and Yekaterinburg are leading by a wide margin.

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03. Amphetamine dealers. In addition to those already mentioned, the top five “fastest” cities included Nizhny Novgorod and Voronezh.

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04. Hashish is in demand, for example, in Kazan and Chelyabinsk.

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05. Cocaine is very expensive, so there are significantly fewer dealers. However, it is strange that it is easier to buy it in Yekaterinburg than in St. Petersburg. It is possible that cheaper powders are sold to local drug addicts under the guise of coke.

06. Mephedrone is a substance that, according to one version, was intended as a synthetic analogue of cocaine... but turned out to be much more dangerous. Moscow is the absolute leader here.

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07. “Cones” – inflorescences of female cannabis plants. They usually contain more psychoactive substances than “grass”, but less than hashish. In both capitals, pine cones are easier to get than anywhere else.

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08. Prices for ecstasy. It’s a little scary for the residents of Bryansk: they are most likely selling aspirin under the guise of MDMA. And ecstasy is probably transported to Ulyanovsk on a golden motorized tire from London.

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09. In general, such a wide range of prices is surprising. For example, speeds in Obninsk simply cannot cost that much, because the city is located not far from Moscow. And in the capital, amphetamines are very common.

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10. Hashish in Moscow is cheap. In Yakutia - expensive. Because if you grow cannabis in permafrost conditions, then you can confuse drugs with fossilized mammoth shit. And Moscow has a cheap supply channel (Central Asia).

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11. There are few heroin offers. Firstly, it is extremely dangerous to both use and sell. Secondly, I suspect that traditional heroin dealers have not yet discovered the dark web.

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12. Cocaine is expensive these days. Dear residents of Dzerzhinsk! Of course, I understand that it’s hard for you without a tram, but this is not a reason to sniff washing powder. By the way, I suspect that all the dealers who sell coke cheaper than in Moscow and St. Petersburg are either selling pure talc, or mercilessly mixing coke with talc, or selling off old stocks. It’s a pity, but Rospotrebnadzor and the FAS won’t be able to set them on.

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13. Mephedrone is more expensive the farther from the capitals (with the exception of Tyumen). This means that either it is actively “cooked” in Moscow and St. Petersburg, or it is brought from somewhere in Europe.

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14. Cheap cones in Crimea. Probably because hemp feels great in the Crimean natural conditions. And even the arrival of Russian drug police instead of Ukrainian ones has not yet changed the situation. Or rather, he changed, but in the eyes of a Muscovite, not very radically. The fact is that in Ukrainian times, Crimea was a free zone, where all sorts of dirty hippies went to live in caves and smoke everything that could be smoked (and this is all not counting the “acid” KaZantip!). I suspect that cones were generally given out to children for free at matinees. That is, even if drug prices increased, for Russians they still turned out to be low.

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15. The cheapest places to be a drug addict are in Vladimir and Krasnoyarsk. This may be due to several factors at once. Firstly, these cities may have “wholesale bases” of dealers. For example, in Vladimir there may well exist a certain “warehouse” for the distribution of drugs in Moscow and Nizhny Novgorod. Secondly, for drug sellers, this may be either a very new or a very old market. Somehow I can’t believe the first one at all, so it’s more likely the second one. If drug addicts of the first few generations completely died out from “crocodile” or other tin, then dealers may well be trying to attract new customers by advertising other types of drugs with promotions and discounts. I'm glad that drugs are very expensive in Omsk. This means that the city will continue to quietly and peacefully drink itself to death. It’s good when someone remains true to traditions.

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** The Drug Directory is intended for informational purposes only. For more complete information, please refer to the manufacturer's instructions. Do not self-medicate; Before you start using Morphine, you should consult a doctor. EUROLAB is not responsible for the consequences caused by the use of information posted on the portal. Any information on the site does not replace medical advice and cannot serve as a guarantee of the positive effect of the drug.

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** Attention! The information presented in this medication guide is intended for medical professionals and should not be used as a basis for self-medication. The description of the drug Morphine is provided for informational purposes and is not intended for prescribing treatment without the participation of a doctor. Patients need to consult a specialist!

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ANTICOAGULANT THERAPY SCHEME FOR COVID-19

1. Anticoagulants are prescribed to ALL hospitalized patients (in the absence of contraindications)

NB! In special cases - the patient's weight is less than 45 kg or more than 145 kg - the dose of the anticoagulant should be calculated individually.

2. If there are clinical or instrumental signs of thrombosis, as well as when initiating pulse therapy, use therapeutic doses of LMWH:

Enoxaparin – 1 mg/kg * 2 times a day or Nadroparin – 0.4 ml (weight < 50 kg), 0.6 ml (weight 50-70 kg) or 0.8 ml (weight > 80 kg) * 2 times a day

3. If there is a pronounced decrease in renal function (eGFR <30 ml/min/1.73 m2), use an individual dosage regimen or UFH (under the control of AST/APTT)

4. Initial therapy with therapeutic doses is used in cases where, before hospitalization, patients received anticoagulants due to atrial fibrillation, after an acute episode of VTEC, after implantation of mechanical prosthetic heart valves

• when taking warfarin: discontinuation, daily INR monitoring, if INR < 2.0, start a therapeutic dose of LMWH, stop INR monitoring
• when taking direct oral anticoagulants (rivaroxaban, dabigatran, apixaban): at the time of the expected intake of the next dose of the drug, administer the first dose of LMWH