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Morphine and heroin also produced higher rates of euphoria and other positive subjective effects when compared to these other opioids. [47] The choice of heroin and morphine over other opioids by former drug addicts may also be because heroin is an ester of morphine and morphine prodrug , essentially meaning they are identical drugs in vivo .
Morphine is the gold standard to which all narcotics are compared. Semi-synthetic derivatives of morphine such as hydromorphone (Dilaudid), oxymorphone (Numorphan, Opana), nicomorphine (Vilan), hydromorphinol and others vary in such ways as duration of action, side effect profile and milligramme potency.
Opiate overdose symptoms and signs can be referred to as the "opioid toxidrome triad": decreased level of consciousness, pinpoint pupils and respiratory depression. Other symptoms include seizures and muscle spasms. Sometimes an opiate overdose can lead to such a decreased level of consciousness such that the person will not wake up.
[9] [7] The effects of morphine withdrawal can range from gastrointestinal disturbances to symptoms like tremors (involuntary shaking, most commonly in hands), opioid cravings, anxiety and insomnia. [10] [11] While morphine withdrawal is not fatal, patients in withdrawal may experience anxiousness, fear and become difficult to manage. [12]
In contrast to natural morphine, the unnatural enantiomer has no affinity or efficacy for the mu opioid receptor and therefore has no analgesic effects. To the contrary, in rats, (+)-morphine acts as an antianalgesic and is approximately 71,000 times more potent as an antianalgesic than (−)-morphine is as an analgesic.
Bradycardia; Hypertension (high blood pressure); Allergic reactions (e.g. dyspnoea (shortness of breath), bronchospasm, wheezing, angioneurotic oedema) Anaphylaxis; Changes in appetite
Miosis and reduced bowel motility tend to persist; little tolerance develops to these effects. [citation needed] The canonical MOR1 isoform is responsible for morphine-induced analgesia, whereas the alternatively spliced MOR1D isoform (through heterodimerization with the gastrin-releasing peptide receptor) is required for morphine-induced itching.
In addition, what appears to be opioid tolerance can be caused by opioid-induced hyperalgesia lowering the baseline pain level, thus masking the drug's analgesic effects. [11] Identifying the development of hyperalgesia is of great clinical importance since patients receiving opioids to relieve pain may paradoxically experience more pain as a ...