Morphine Preparations and Doses

Questions and Answers

What is a significant adverse effect of morphine that can develop with prolonged use?

Weight gain

Tolerance (correct)

Increased sensitivity to pain

Improved respiratory function

Which of the following is a contraindication for morphine use?

Bronchial asthma (correct)

Seasonal allergies

Chronic pain

Mild headache

What is the primary reason for limiting morphine use in patients with head injuries?

Respiratory depression leading to CO2 retention (correct)

Nausea and vomiting

Increased energy levels

Increased tolerance

Which adverse effect is specifically associated with the gastrointestinal system when using morphine?

Constipation Signup and view all the answers

In which situation would morphine likely lead to urinary retention?

In patients with enlarged prostate Signup and view all the answers

What common side effect of morphine involves a change in pupil size?

Miosis Signup and view all the answers

Why should morphine be used cautiously in patients with biliary colic?

It causes spasm of the sphincter of Oddi Signup and view all the answers

What condition is implicated to potentially worsen due to postural hypotension from morphine?

Hypotension and hypovolemia Signup and view all the answers

What is a potential consequence of morphine use in patients with hepatic damage?

Increased risk of hepatic encephalopathy Signup and view all the answers

How does undiagnosed acute abdominal pain pose a risk when administering morphine?

It may lead to delayed surgical intervention Signup and view all the answers

Which group of patients is most susceptible to respiratory depression from morphine?

Infants and elderly patients Signup and view all the answers

What is one of the major manifestations of acute opioid toxicity?

Coma with depressed respiration Signup and view all the answers

What is the recommended treatment for chronic morphine addiction?

Gradual withdrawal with substitution by methadone Signup and view all the answers

Which symptom is associated with sudden withdrawal from morphine?

Muscle cramps Signup and view all the answers

What is a significant mechanism involved in opioid withdrawal symptoms?

Rebound increase of norepinephrine release Signup and view all the answers

What is a critical step in the management of acute opioid toxicity?

Performing gastric lavage Signup and view all the answers

Morphine can lead to physical dependence within 48 hours of use.

False Signup and view all the answers

Respiratory depression from morphine is not influenced by dosage.

False Signup and view all the answers

Intrathecal morphine injection is used for short-term analgesia.

False Signup and view all the answers

Morphine administration can result in increased intracranial tension.

True Signup and view all the answers

Bronchoconstriction is a known side effect of morphine particularly due to vagal stimulation.

True Signup and view all the answers

Morphine does not affect urinary retention in patients with an enlarged prostate.

False Signup and view all the answers

Tolerance to respiratory depression does not develop with prolonged morphine use.

True Signup and view all the answers

Nausea and vomiting are common gastrointestinal effects of morphine.

True Signup and view all the answers

Morphine can mask the symptoms of appendicitis by masking acute abdominal pain.

True Signup and view all the answers

Chronic administration of opioids results in an increased endogenous production of endorphins.

False Signup and view all the answers

Infants and elderly patients exhibit a lower susceptibility to respiratory depression caused by morphine.

False Signup and view all the answers

Following sudden withdrawal from morphine, there is an increased release of norepinephrine.

True Signup and view all the answers

Opioid blockers are recommended as an initial treatment for chronic opioid toxicity.

False Signup and view all the answers

Patients with adrenal insufficiency have a normal response to morphine.

False Signup and view all the answers

Gastric lavage is a common treatment for opioid withdrawal syndrome.

False Signup and view all the answers

Morphine is metabolized by the liver, which contributes to its risk of hepatic encephalopathy.

True Signup and view all the answers

What effect does chronic opioid use have on endogenous opioid production?

Chronic opioid use decreases endogenous opioid production. Signup and view all the answers

How does morphine impact patients with undiagnosed acute abdominal pain?

Morphine can mask the pain, which may hinder proper diagnosis. Signup and view all the answers

What therapy is recommended for managing chronic morphine addiction?

Gradual withdrawal of morphine with substitution by methadone is recommended. Signup and view all the answers

Identify a significant risk associated with morphine in infants and the elderly.

Infants and the elderly are at increased risk of respiratory depression. Signup and view all the answers

What are the initial symptoms of sudden withdrawal from morphine?

Initial symptoms include irritability, nervousness, and tremors. Signup and view all the answers

What critical intervention is necessary for acute opioid toxicity?

Establishing a patent airway is critical in acute opioid toxicity. Signup and view all the answers

Explain the mechanism behind rebound norepinephrine release during opioid withdrawal.

Chronic use leads to reduced norepinephrine levels, causing rebound release upon withdrawal. Signup and view all the answers

What is a potential consequence of morphine use in patients with hepatic damage?

Patients may experience an increased risk of hepatic encephalopathy. Signup and view all the answers

How does the route of administration affect the dosage of morphine in acute myocardial infarction?

In acute myocardial infarction, morphine is administered at a dose of 5 mg intravenously for rapid effect. Signup and view all the answers

Identify a potential risk associated with the use of morphine in patients with head injuries.

Morphine can exacerbate increased intracranial pressure and cause respiratory depression. Signup and view all the answers

What is the significance of tolerance in morphine treatment concerning its analgesic effects?

Tolerance may develop to analgesia, requiring higher doses for the same pain relief, but not to respiratory depression. Signup and view all the answers

Explain how morphine administration can affect patients with gallstones.

Morphine can cause spasm of the sphincter of Oddi, increasing biliary pressure and possibly leading to biliary colic. Signup and view all the answers

What common ocular symptom is seen in patients dependent on morphine?

Miosis, or constricted pupils, is a consistent finding in morphine addiction. Signup and view all the answers

What precautions should be taken when administering morphine to patients with respiratory conditions?

Morphine can cause bronchoconstriction and respiratory depression, requiring careful monitoring in these patients. Signup and view all the answers

How might morphine influence urinary function in male patients with enlarged prostates?

Morphine can increase detrusor muscle tone and lead to urinary retention, complicating micturition. Signup and view all the answers

Describe one major adverse effect of morphine on the central nervous system.

One major adverse effect is the potential for respiratory depression, which can be dose-dependent. Signup and view all the answers

In acute myocardial infarction, morphine is administered at a dose of ______ mg intravenously.

5 Signup and view all the answers

One of the significant adverse effects of morphine is respiratory ______, which is dose-dependent.

depression Signup and view all the answers

Morphine can lead to ______ tension due to its effects on the central nervous system.

intracranial Signup and view all the answers

Patients with an enlarged prostate may experience urinary ______ as a side effect of morphine.

retention Signup and view all the answers

Morphine causes bronchoconstriction, which is particularly due to ______ stimulation.

vagal Signup and view all the answers

Effective pain relief in critically ill patients can be achieved through intrathecal injection of ______ morphine.

epidural Signup and view all the answers

One contraindication for morphine use is ______ injury due to the risk of respiratory depression.

head Signup and view all the answers

Postural hypotension can be caused by morphine, which may lead to ______ effects in patients.

hypovolemic Signup and view all the answers

Chronic administration of opioids decreases endogenous production of ______.

endorphins Signup and view all the answers

Infants and elderly patients are more susceptible to respiratory ______.

depression Signup and view all the answers

Morphine can mask the symptoms of appendicitis by masking acute abdominal ______.

pain Signup and view all the answers

Sudden withdrawal from morphine can lead to symptoms such as irritability, nervousness, and ______.

tremors Signup and view all the answers

Acute opioid toxicity may manifest as coma with depressed respiration, miosis, and ______.

shock Signup and view all the answers

Treatment for chronic morphine addiction may involve gradual withdrawal with substitution by ______.

methadone Signup and view all the answers

Opioid blockers can be used in the management of acute ______ toxicity.

opioid Signup and view all the answers

Morphine increases the risk of hepatic encephalopathy due to marked CNS ______.

depression Signup and view all the answers

Match the following routes of morphine administration with their effects:

Intrathecal injection = Long-lasting analgesia for critically ill patients Intravenous injection in acute MI = 5 mg dosage Subcutaneous administration = Typical onset for chronic pain management Transdermal patches = Sustained release preparations Signup and view all the answers

Match the major adverse effects of morphine with their descriptions:

Tolerance = Reduction in drug effect with prolonged use Respiratory depression = Increased risk of CO2 retention Miosis = Constricted pupils associated with addiction Postural hypotension = Decreased blood pressure upon standing Signup and view all the answers

Match the contraindications of morphine with their implications:

Head injury = Increased intracranial pressure risk Bronchial asthma = Causes bronchoconstriction Biliary colic = Increased biliary pressure and pain Enlarged prostate = Risk of urinary retention and urgency Signup and view all the answers

Match the following adverse gastrointestinal effects with their characteristics:

Nausea = Common side effect during morphine use Vomiting = Can occur alongside nausea Constipation = Significant and persisting issue Biliary colic = Caused by increased biliary tract pressure Signup and view all the answers

Match the physiological effects of morphine with their systems affected:

CNS = Cognitive disturbance and dependence potential Respiratory = Can lead to bronchoconstriction Cardiovascular = May cause postural hypotension Genitourinary = Can result in urine retention and difficulty Signup and view all the answers

Match the onset timeframes for morphological effects with their corresponding conditions:

Physical dependence = Can occur within 24 hours of continuous use Tolerance to euphoria = Develops at a similar rate to analgesia Respiratory depression = Dose-dependent and can vary significantly Urinary retention = Associated with use in patients with prostate issues Signup and view all the answers

Match the morphine side effects with their specific characteristics:

CNS effects = Include tolerance and addiction potential Respiratory effects = Primarily dose-dependent depression GIT effects = Often include significant constipation Ocular effects = Notable miosis in cases of addiction Signup and view all the answers

Match the following morphine preparations with their usage scenarios:

Sustained release preparations = Used for chronic pain management Intravenous administration = Preferred in acute myocardial infarction Transdermal patches = Provide long-term analgesic coverage Intrathecal injection = Effective for critically ill patients needing prolonged relief Signup and view all the answers

Match the following conditions with their respective implications when using morphine:

Hepatic damage = Increased risk of hepatic encephalopathy Addison’s disease = Prolonged and exaggerated response Undiagnosed acute abdominal pain = Masks symptoms of appendicitis Infants and elderly patients = Increased susceptibility to respiratory depression Signup and view all the answers

Match the following symptoms with their associated conditions:

Chronic opioid toxicity = Behavioral changes and miosis Sudden withdrawal = Irritability and hypertension Acute opioid toxicity = Coma with depressed respiration Gastric lavage = Treatment for acute toxicity Signup and view all the answers

Match the following treatment methods with their corresponding indications:

Gradual withdrawal of morphine = Management of chronic morphine addiction Clonidine = Stimulate central α2 receptors to decrease NA release Methadone substitution = Alternative during morphine withdrawal Opioid blockers = Used in acute morphine toxicity management Signup and view all the answers

Match the following neurochemical changes to their relevant situations involving opioids:

Chronic opioid use = Decreased endogenous endorphin production Sudden withdrawal = Increased norepinephrine release Physical dependence = Deficiency of endogenous opioids Acute toxicity = Respiratory depression leading to death Signup and view all the answers

Match the following withdrawal symptoms with their onset timings:

Irritability = Starts after 6-10 hours from the last dose Tremors = Peaks at 48 hours Nervousness = Gradually subsides over 5-10 days Muscle cramps = Occurs during withdrawal symptoms Signup and view all the answers

Match the following characteristics with their associated groups affected by opioids:

Infants = Higher susceptibility to respiratory depression Elderly = Increased risk from CNS depression Patients with hepatic damage = Risk of exacerbated encephalopathy Addison's disease patients = Prolonged reaction to opioids Signup and view all the answers

Match the following opioid effects with their related complications:

Respiratory depression = Potentially fatal in overdose CNS depression = Complicates diagnosis in acute abdominal pain Miosis = Characteristic sign of opioid use Constipation = Common side effect of chronic use Signup and view all the answers

Match the following conditions with the appropriate need for caution regarding morphine use:

Head injuries = Risk of increased intracranial pressure Gallstones = May intensify biliary colic episodes Prostatic hypertrophy = Increased urinary retention risk Respiratory conditions = Heightened risk of respiratory depression Signup and view all the answers

Study Notes

Morphine Sulfate Preparations and Doses

Administered as 10 mg subcutaneously or intramuscularly; 5 mg intravenous in acute myocardial infarction.
Intrathecal (epidural) injection provides long-lasting analgesia, particularly beneficial for critically ill patients prone to respiratory depression.
Available in sustained release formulations and transdermal patches.

Adverse Effects

CNS Effects
- Prolonged use can lead to tolerance and physical dependence; physical dependence may develop within 24 hours with use every 4 hours.
- Tolerance develops for analgesia and euphoria but not for respiratory depression.
- Increased intracranial tension and dose-dependent respiratory depression are notable risks.
Respiratory System
- Bronchoconstriction is a potential adverse effect.
Cardiovascular System
- May cause postural hypotension.
Gastrointestinal Tract
- Common effects include nausea, vomiting, constipation, increased biliary tract pressure, and potential biliary colic.
Genitourinary System
- Urinary retention can occur especially in patients with enlarged prostates; may prolong labor.
Ocular Effects
- Miosis is a consistent sign of morphine addiction.

Contraindications and Precautions

Contraindicated in head injuries and conditions with increased intracranial pressure due to risk of respiratory depression and CO2 retention.
Not suitable for patients with bronchial asthma because it can induce bronchoconstriction, respiratory depression, and histamine release.
Use caution in patients with biliary colic or gallstones as morphine can increase biliary pressure.
Patients with senile enlarged prostate may experience urinary urgency and difficulty urinating due to increased detrusor muscle tone.
Hypotension risks due to the potential for postural hypotension.
Contraindicated in hepatic damage due to metabolic processing in the liver and increased CNS depression.
Patients with hypothyroidism or adrenal insufficiency may have exaggerated responses to morphine.
Should not be used in cases of undiagnosed acute abdominal pain as it can mask symptoms and delay diagnosis.
Infants and elderly individuals are at greater risk for respiratory depression.

Chronic Opioid Toxicity

Symptoms include behavioral changes, constipation, itching, and miosis.
Sudden withdrawal may lead to irritability, nervousness, tremors, hypertension, and muscle cramps starting 6-10 hours after the last dose, peaking at 48 hours and subsiding over 5-10 days.
Mechanism involves chronic opioid use decreasing endogenous endorphin and norepinephrine levels, leading to withdrawal symptoms due to sudden deficiency of endogenous opioids.

Treatment of Chronic Morphine Addiction

Should include gradual withdrawal of morphine, substituted with methadone, followed by a gradual tapering off methadone.
Clonidine can be used to stimulate central alpha-2 receptors, reducing norepinephrine release.
Sedatives like diazepam may aid in managing symptoms during withdrawal.

Acute Opioid Toxicity

Signs include coma, depressed respiration, miosis, and shock; death typically results from respiratory depression.
Treatment involves gastric lavage, ensuring a patent airway, and providing artificial respiration as necessary.

Morphine Sulfate Preparations and Doses

Administered as 10 mg subcutaneously or intramuscularly; 5 mg intravenous in acute myocardial infarction.
Intrathecal (epidural) injection provides long-lasting analgesia, particularly beneficial for critically ill patients prone to respiratory depression.
Available in sustained release formulations and transdermal patches.

Adverse Effects

CNS Effects
- Prolonged use can lead to tolerance and physical dependence; physical dependence may develop within 24 hours with use every 4 hours.
- Tolerance develops for analgesia and euphoria but not for respiratory depression.
- Increased intracranial tension and dose-dependent respiratory depression are notable risks.
Respiratory System
- Bronchoconstriction is a potential adverse effect.
Cardiovascular System
- May cause postural hypotension.
Gastrointestinal Tract
- Common effects include nausea, vomiting, constipation, increased biliary tract pressure, and potential biliary colic.
Genitourinary System
- Urinary retention can occur especially in patients with enlarged prostates; may prolong labor.
Ocular Effects
- Miosis is a consistent sign of morphine addiction.

Contraindications and Precautions

Contraindicated in head injuries and conditions with increased intracranial pressure due to risk of respiratory depression and CO2 retention.
Not suitable for patients with bronchial asthma because it can induce bronchoconstriction, respiratory depression, and histamine release.
Use caution in patients with biliary colic or gallstones as morphine can increase biliary pressure.
Patients with senile enlarged prostate may experience urinary urgency and difficulty urinating due to increased detrusor muscle tone.
Hypotension risks due to the potential for postural hypotension.
Contraindicated in hepatic damage due to metabolic processing in the liver and increased CNS depression.
Patients with hypothyroidism or adrenal insufficiency may have exaggerated responses to morphine.
Should not be used in cases of undiagnosed acute abdominal pain as it can mask symptoms and delay diagnosis.
Infants and elderly individuals are at greater risk for respiratory depression.

Chronic Opioid Toxicity

Symptoms include behavioral changes, constipation, itching, and miosis.
Sudden withdrawal may lead to irritability, nervousness, tremors, hypertension, and muscle cramps starting 6-10 hours after the last dose, peaking at 48 hours and subsiding over 5-10 days.
Mechanism involves chronic opioid use decreasing endogenous endorphin and norepinephrine levels, leading to withdrawal symptoms due to sudden deficiency of endogenous opioids.

Treatment of Chronic Morphine Addiction

Should include gradual withdrawal of morphine, substituted with methadone, followed by a gradual tapering off methadone.
Clonidine can be used to stimulate central alpha-2 receptors, reducing norepinephrine release.
Sedatives like diazepam may aid in managing symptoms during withdrawal.

Acute Opioid Toxicity

Signs include coma, depressed respiration, miosis, and shock; death typically results from respiratory depression.
Treatment involves gastric lavage, ensuring a patent airway, and providing artificial respiration as necessary.

Morphine Sulfate Preparations and Doses

Administered as 10 mg subcutaneously or intramuscularly; 5 mg intravenous in acute myocardial infarction.
Intrathecal (epidural) injection provides long-lasting analgesia, particularly beneficial for critically ill patients prone to respiratory depression.
Available in sustained release formulations and transdermal patches.

Adverse Effects

CNS Effects
- Prolonged use can lead to tolerance and physical dependence; physical dependence may develop within 24 hours with use every 4 hours.
- Tolerance develops for analgesia and euphoria but not for respiratory depression.
- Increased intracranial tension and dose-dependent respiratory depression are notable risks.
Respiratory System
- Bronchoconstriction is a potential adverse effect.
Cardiovascular System
- May cause postural hypotension.
Gastrointestinal Tract
- Common effects include nausea, vomiting, constipation, increased biliary tract pressure, and potential biliary colic.
Genitourinary System
- Urinary retention can occur especially in patients with enlarged prostates; may prolong labor.
Ocular Effects
- Miosis is a consistent sign of morphine addiction.

Contraindications and Precautions

Contraindicated in head injuries and conditions with increased intracranial pressure due to risk of respiratory depression and CO2 retention.
Not suitable for patients with bronchial asthma because it can induce bronchoconstriction, respiratory depression, and histamine release.
Use caution in patients with biliary colic or gallstones as morphine can increase biliary pressure.
Patients with senile enlarged prostate may experience urinary urgency and difficulty urinating due to increased detrusor muscle tone.
Hypotension risks due to the potential for postural hypotension.
Contraindicated in hepatic damage due to metabolic processing in the liver and increased CNS depression.
Patients with hypothyroidism or adrenal insufficiency may have exaggerated responses to morphine.
Should not be used in cases of undiagnosed acute abdominal pain as it can mask symptoms and delay diagnosis.
Infants and elderly individuals are at greater risk for respiratory depression.

Chronic Opioid Toxicity

Symptoms include behavioral changes, constipation, itching, and miosis.
Sudden withdrawal may lead to irritability, nervousness, tremors, hypertension, and muscle cramps starting 6-10 hours after the last dose, peaking at 48 hours and subsiding over 5-10 days.
Mechanism involves chronic opioid use decreasing endogenous endorphin and norepinephrine levels, leading to withdrawal symptoms due to sudden deficiency of endogenous opioids.

Treatment of Chronic Morphine Addiction

Should include gradual withdrawal of morphine, substituted with methadone, followed by a gradual tapering off methadone.
Clonidine can be used to stimulate central alpha-2 receptors, reducing norepinephrine release.
Sedatives like diazepam may aid in managing symptoms during withdrawal.

Acute Opioid Toxicity

Signs include coma, depressed respiration, miosis, and shock; death typically results from respiratory depression.
Treatment involves gastric lavage, ensuring a patent airway, and providing artificial respiration as necessary.

Morphine Sulfate Preparations and Doses

Administered as 10 mg subcutaneously or intramuscularly; 5 mg intravenous in acute myocardial infarction.
Intrathecal (epidural) injection provides long-lasting analgesia, particularly beneficial for critically ill patients prone to respiratory depression.
Available in sustained release formulations and transdermal patches.

Adverse Effects

CNS Effects
- Prolonged use can lead to tolerance and physical dependence; physical dependence may develop within 24 hours with use every 4 hours.
- Tolerance develops for analgesia and euphoria but not for respiratory depression.
- Increased intracranial tension and dose-dependent respiratory depression are notable risks.
Respiratory System
- Bronchoconstriction is a potential adverse effect.
Cardiovascular System
- May cause postural hypotension.
Gastrointestinal Tract
- Common effects include nausea, vomiting, constipation, increased biliary tract pressure, and potential biliary colic.
Genitourinary System
- Urinary retention can occur especially in patients with enlarged prostates; may prolong labor.
Ocular Effects
- Miosis is a consistent sign of morphine addiction.

Contraindications and Precautions

Contraindicated in head injuries and conditions with increased intracranial pressure due to risk of respiratory depression and CO2 retention.
Not suitable for patients with bronchial asthma because it can induce bronchoconstriction, respiratory depression, and histamine release.
Use caution in patients with biliary colic or gallstones as morphine can increase biliary pressure.
Patients with senile enlarged prostate may experience urinary urgency and difficulty urinating due to increased detrusor muscle tone.
Hypotension risks due to the potential for postural hypotension.
Contraindicated in hepatic damage due to metabolic processing in the liver and increased CNS depression.
Patients with hypothyroidism or adrenal insufficiency may have exaggerated responses to morphine.
Should not be used in cases of undiagnosed acute abdominal pain as it can mask symptoms and delay diagnosis.
Infants and elderly individuals are at greater risk for respiratory depression.

Chronic Opioid Toxicity

Symptoms include behavioral changes, constipation, itching, and miosis.
Sudden withdrawal may lead to irritability, nervousness, tremors, hypertension, and muscle cramps starting 6-10 hours after the last dose, peaking at 48 hours and subsiding over 5-10 days.
Mechanism involves chronic opioid use decreasing endogenous endorphin and norepinephrine levels, leading to withdrawal symptoms due to sudden deficiency of endogenous opioids.

Treatment of Chronic Morphine Addiction

Should include gradual withdrawal of morphine, substituted with methadone, followed by a gradual tapering off methadone.
Clonidine can be used to stimulate central alpha-2 receptors, reducing norepinephrine release.
Sedatives like diazepam may aid in managing symptoms during withdrawal.

Acute Opioid Toxicity

Signs include coma, depressed respiration, miosis, and shock; death typically results from respiratory depression.
Treatment involves gastric lavage, ensuring a patent airway, and providing artificial respiration as necessary.

Morphine Sulfate Preparations and Doses

Administered as 10 mg subcutaneously or intramuscularly; 5 mg intravenous in acute myocardial infarction.
Intrathecal (epidural) injection provides long-lasting analgesia, particularly beneficial for critically ill patients prone to respiratory depression.
Available in sustained release formulations and transdermal patches.

Adverse Effects

CNS Effects
- Prolonged use can lead to tolerance and physical dependence; physical dependence may develop within 24 hours with use every 4 hours.
- Tolerance develops for analgesia and euphoria but not for respiratory depression.
- Increased intracranial tension and dose-dependent respiratory depression are notable risks.
Respiratory System
- Bronchoconstriction is a potential adverse effect.
Cardiovascular System
- May cause postural hypotension.
Gastrointestinal Tract
- Common effects include nausea, vomiting, constipation, increased biliary tract pressure, and potential biliary colic.
Genitourinary System
- Urinary retention can occur especially in patients with enlarged prostates; may prolong labor.
Ocular Effects
- Miosis is a consistent sign of morphine addiction.

Contraindications and Precautions

Contraindicated in head injuries and conditions with increased intracranial pressure due to risk of respiratory depression and CO2 retention.
Not suitable for patients with bronchial asthma because it can induce bronchoconstriction, respiratory depression, and histamine release.
Use caution in patients with biliary colic or gallstones as morphine can increase biliary pressure.
Patients with senile enlarged prostate may experience urinary urgency and difficulty urinating due to increased detrusor muscle tone.
Hypotension risks due to the potential for postural hypotension.
Contraindicated in hepatic damage due to metabolic processing in the liver and increased CNS depression.
Patients with hypothyroidism or adrenal insufficiency may have exaggerated responses to morphine.
Should not be used in cases of undiagnosed acute abdominal pain as it can mask symptoms and delay diagnosis.
Infants and elderly individuals are at greater risk for respiratory depression.

Chronic Opioid Toxicity

Symptoms include behavioral changes, constipation, itching, and miosis.
Sudden withdrawal may lead to irritability, nervousness, tremors, hypertension, and muscle cramps starting 6-10 hours after the last dose, peaking at 48 hours and subsiding over 5-10 days.
Mechanism involves chronic opioid use decreasing endogenous endorphin and norepinephrine levels, leading to withdrawal symptoms due to sudden deficiency of endogenous opioids.

Treatment of Chronic Morphine Addiction

Should include gradual withdrawal of morphine, substituted with methadone, followed by a gradual tapering off methadone.
Clonidine can be used to stimulate central alpha-2 receptors, reducing norepinephrine release.
Sedatives like diazepam may aid in managing symptoms during withdrawal.

Acute Opioid Toxicity

Signs include coma, depressed respiration, miosis, and shock; death typically results from respiratory depression.
Treatment involves gastric lavage, ensuring a patent airway, and providing artificial respiration as necessary.

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Description

This quiz covers the preparations, dosing guidelines, and adverse effects of morphine sulphate. It includes details on different administration routes such as subcutaneous, intravenous, and epidural injections, as well as the implications of prolonged use. Test your knowledge on morphine management in acute settings.