Morphine and other opioids

Morphine will be described in detail and other opioid analgesics principally in so far as they differ. Morphine acts mainly on the opioid p,-receptor (analgesia, euphoria, dependence) and p2-receptors (respiratory depression, reduced gut motility). The principal actions of morphine may be summarised:

On the central nervous system:

• Depression, leading to: analgesia, respiratory depression, depression of cough reflex, sleep

• Excitation, leading to: vomiting, miosis, hyperactive spinal cord reflexes (some only), convulsions (very rare)

• Changes of mood: euphoria or dysphoria

• Dependence; affects other systems too.

Peripheral nervous system:

• Analgesia, some anti-inflammatory effect

Smooth muscle stimulation:

• Gastrointestinal muscle spasm (delayed passage of contents with constipation)

• Biliary tract spasm

• Bronchospasm

Cardiovascular system:

• Dilatation of resistance (arterioles) and capacitance (veins) vessles.

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Constipation Prescription

Constipation Prescription

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