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Introduction

  • Morphine is the main active compound in opium, the juice obtained from the seed pods of the poppy plant Papaver Somniferum, and has been widely used for centuries for means both medical and recreational.

  • Morphine was first isolated from opium in 1805 by a German pharmacist, Wilhelm Sertürner. Sertürner described it as the Principium Somniferum. He named it morphium - after Morpheus, the Greek god of dreams. Today morphine is isolated from opium in substantially larger quantities - over 1000 tons per year.

  • Its users range from medical patients with acute or chronic pain, to occasional users of opiates, sometimes known as “chippers”, to habitual daily users.

  • This drug is useful in medicine as a painkiller, antitussive, and for its smooth muscle constricting properties.

Uses

  • Morphine is primarily used to treat both acute and chronic pain.It is also used for pain due to myocardial infarction and for labor pains.

  • Morphine has also traditionally been used in the treatment of the acute pulmonary edema. Immediate release morphine is beneficial in reducing the symptom of shortness of breath due to both cancer and non cancer causes.

  • It is used also, especially in combination with kaolin or (in paediatric patients) as a component in tincture of opium, to alleviate mild dry cough and diarrhoea.

  • Morphine is also occasionally used off-label for its beneficial effects upon the mind, notably as an anxiolytic and
    antidepressant.

Mechanism of action

  • The precise mechanism of the analgesic action of morphine is unknown. However, specific CNS opiate receptors have been identified and likely play a role in the expression of analgesic effects.

  • Morphine first acts on the mu-opioid receptors. The mechanism of respiratory depression involves a reduction in the responsiveness of the brain stem respiratory centers to increases in carbon dioxide tension and to electrical stimulation.

  • It has been shown that morphine binds to and inhibits GABA inhibitory interneurons. These interneurons normally inhibit the descending pain inhibition pathway. So, without the inhibitory signals, pain modulation can proceed downstream.

Effects of Morphine

  • Morphine constricts smooth muscles, and increases the water uptake of cells from organs like the sphincter and intestines, which can make it useful in treating chronic diarrhea. Because of this, its use as an antidiarrheal agent is found often in third-world countries where poor sanitation can lead to gastrointestinal disorders .

  • When morphine was first isolated and utilized by doctors, it was prescribed for other uses as well. These less common treatments include depression, since there is a minority opinion that certain depressions may be due less to differences in serotonin levels, and more to inadequate levels of natural endorphins and enkephalins.

  • While this is no longer a legitimate use for morphine due to its potential for abuse and addiction, the effect of such studies and ideas can be seen in more recent efforts to treat addiction with “safer”, less addictive synthetic opioids such as buprenorphine.

  • Some mu-opioid receptors inhibit the cough reflex, and morphine was marketed early on in cough remedies as a powerful antitussive. While the non-narcotic dextromethorphan has for the most part filled this role today, a remnant of this early use of morphine can be seen in the use of codeine to treat coughs around the world.

  • Characteristic of physicians’ enthusiasm for more newly-introduced drugs over old remedies, morphine had also been used as a treatment for opium addiction and in early studies on opium withdrawal, where it was revealed that injections of morphine would reverse withdrawal symptoms in both animals and man.

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