Morphine (Injection)

Morphine is a strong painkiller belonging to the category opioid analgesics.

Overview

Morphine injections are a form of medication used to treat patients suffering from severe pain. Morphine is a type of opioid analgesic, which is a form of narcotic.

Morphine injections are often administered to patients in hospital following major surgery or serious traumatic injuries. It can also be used for cancer patients, or for those recovering from a heart attack. For patients suffering from long-term and chronic pain, morphine can be used when weaker painkillers have stopped being effective.

Morphine is an extremely strong and powerful form of medication which is controlled strictly by the health authorities. It is therefore only available on prescription and is usually only administered in hospitals, hospices and other institutions where trained medical professionals are on hand to monitor patients after treatment with morphine.

As an opioid analgesic, morphine works by attaching to one or more of the brain's opiate receptors. It is injected into a muscle and travels through the bloodstream into the brain. The receptors in the brain are stimulated and this reduces the patient's pain without treating its root cause.

Morphine is a strong medication, and the side effects can, therefore, be severe. This is one of the main reasons why its use is strictly monitored by qualified healthcare professionals. Morphine slows down the function of the gut, causing severe constipation. It also causes patients to become drowsy and sleepy and can slow down the respiratory system, making it harder for patients to absorb as much oxygen into their bloodstream. It can also cause severe nausea, and in some cases, provoke serious reactions.

Morphine relieves pain and stimulates the brain into a state of euphoria, producing similar effects as the recreational drug heroin. It can, therefore, become addictive, causing patients to depend on the way in which it alters their brain activity. This is another of the reasons behind the strict regulation and control of morphine. It is very rare for patients to become addicted to this drug when it is administered according to professional guidelines and monitored by qualified healthcare professionals. However, without these processes in place, it is likely that addiction rates would be much higher.

Conditions Treated

  • Severe pain

Type Of Medicine

  • Opioid analgesic

Side Effects

Morphine is a powerful drug which alters the way in which the brain responds to pain. In order to work, it has to make significant changes within the body, which do not come without the risk of side effects. As with all drugs, before prescribing morphine, healthcare professionals will weigh up the possible side effects against the positive impact of the drug on the patient's health. A doctor will only prescribe morphine if they believe that the potential benefits outweigh the risk of possible side effects.

There are some side effects of morphine which are relatively common and relatively easy to treat or manage. These include:

  • Constipation
  • Nausea
  • Dry mouth
  • Vomiting
  • Light-headedness and drowsiness
  • Dizziness
  • Sweating
  • Pain and/or welling at the site of the injection

To prevent constipation, patients are advised to have a high-fiber diet whilst being treated with morphine and that they get plenty of fluids. Exercise has also been proven effective but this is often not possible due to the condition of many patients who require morphine treatment. Some patients may need to be prescribed a laxative in order to counteract the constipation.

To prevent the patient from suffering from dizziness or light-headedness, they should move from get up slowly and not make sharp movements of any kind.

It rarer cases, patients can experience serious side effects as a result of taking morphine. Patients should seek urgent medical attention if they experience any of the following:

  • Changes in mood
  • Agitation
  • Difficulty in passing urine
  • Severe abdominal pains
  • Extreme tiredness
  • Unexplained weight loss
  • Hallucinations
  • Extreme confusion
  • Changes in eyesight
  • Loss of appetite
  • Heart beating too fast or too slow

In very rare cases, patients may experience the following symptoms as severe side effects of taking morphine:

  • Fainting
  • Seizures
  • Shallow breathing
  • Difficulty waking up
  • Severe drowsiness
  • Changes to menstruation cycles
  • Itching, rashes or hives

Patients should seek urgent medical attention if they experience any of the symptoms listed above as it may be an indicator that the dose of morphine they are receiving is too high.

Morphine is a potentially addictive substance. If the patient's morphine intake is not regulated properly, it is possible that they could experience withdrawal symptoms when coming off the drug. This is most likely to be the case when patients have been taking the drug for a long time or in high doses. Symptoms of a withdrawal reaction include:

  • Restlessness
  • Widened pupils
  • Runny nose
  • Sweating
  • Agitation
  • Insomnia
  • Watering eyes
  • Anxiety
  • Aching muscles
  • Diarrhea
  • Vomiting
  • Nausea
  • Abdominal cramps

It extremely rare for patients to experience a severe allergic reaction to morphine; however, it is possible. Patients who have been diagnosed with a morphine allergy often have to wear an item of medical jewelry to ensure that they would not be administered morphine in case of an emergency. Symptoms of an allergic reaction include:

  • Swelling of the face, tongue and/or throat
  • Severe dizziness
  • Difficulty breathing
  • Rashes
  • Swelling
  • Itchiness

Patients who experience any of the symptoms listed above should alert their doctor immediately so that they can investigate the possibility of an allergic reaction and change the course of treatment if required.

Dosage

Morphine injections are administered via a syringe and are usually injected straight into a muscle. There are also some instances in which morphine is injected into the spinal cord, this is known as an epidural and is commonly used for women giving birth. If patients are being given the drug in hospital, it is usually injected by a doctor. Patients receiving morphine treatment in the home may have an infusion pump fitted which administers a continuous injection.

The prescribed dosage of morphine will vary depending on various factors.

  • The patient's age
  • The patient's weight
  • The severity of the pain
  • Any other medications they are currently taking
  • The duration of the pain
  • The patient's responsiveness to the medication

Doctors will weigh up all of these factors, and many more, in order to make a decision about the prescribed dosage of morphine. They may test a small dose and increase where necessary. This type of pain medication usually works most effectively if used at the first sign of pain. Morphine can be less effective if the pain worsens before the medication is given.

It is possible to overdose on morphine. Signs of overdose include the following symptoms:

  • Small, contracted pupils
  • Unusually slow heartbeat
  • Changes in vision and eyesight
  • Losing consciousness
  • Changes in breathing
  • Difficulty breathing
  • Skin which is cold and clammy to the touch
  • Nausea
  • Fainting

Patients who experience any of the symptoms listed above should alert their doctor immediately or seek urgent medical attention. It may be that the dose of morphine being prescribed needs to be lowered.

Interactions

When two or more chemicals are combined within the body, there is always the possibility of interactions. Interactions between different pharmaceuticals could interfere with the way in which the medications work, could increase the risk of side effects associated with one or more of the drugs and could produce altogether different side effects. It is extremely important for patients to keep an up-to-date and accurate record of all of the drugs, both prescribed and non-prescribed, that they are currently taking.

Morphine can interact with some lab tests, causing false results. Tests for amylase or lipase levels may appear different for patients taking morphine. If you are having any lab tests performed, make sure to let the technicians aware that you are currently taking morphine.

The risk of certain side effects, such as difficulty in breathing and severe drowsiness, are increased when morphine is combined with other products which can cause these side effects. If taking non-prescription drugs at the same time as morphine, make sure that you read all of the labeling to ensure that they do not have these side effects. Some of these products include:

  • Codeine
  • Hydrocodone
  • Alcohol
  • Cough relief medication
  • Other opioids
  • Sleeping tablets
  • Anxiety medication
  • Marijuana
  • Muscle relaxants
  • Antihistamines

Other drugs known to cause interactions with morphine include:

  • Pentazocine
  • Naltrexone
  • Butorphanol
  • Nalbuphine
  • Opiates
  • Recreational narcotics

Remember that before prescribing a drug, doctors will weigh up the risk of interaction with other medication that the patient is currently taking. The only way in which they can do this accurately is if they have an up-to-date and accurate list of all of the substances currently being taken by the patient. This list should include all dietary supplements, over-the-counter medication, street drugs and prescribed medication.

Warnings

A visual check of the ampules of injectable morphine should always be performed to ensure that there is no discoloration of the liquid and there are no particles present. The morphine should not be used if either of these are present.

This medication comes with a risk of addiction. Although it is a prescribed medication and is not meant to be used recreationally, addiction and dependence are both possibilities. The risk of addiction is greatly increased for patients who have previously struggled with a substance abuse disorder. In order to avoid addiction, doses should be kept as low as possible whilst still being effective as a method of pain relief.

Interactions do not just happen between two or more pharmaceuticals; they can also occur between a drug and a medical condition. In some circumstances, morphine can cause unintended effects when combined with a pre-existing medical condition. Doctors should have full access to a patient's medical history, but they should be made especially aware if they have suffered from any of the following conditions:

  • Brain disorders
  • Brain tumor
  • Seizures
  • Severe head injury
  • Asthma
  • COPD (chronic obstructive pulmonary disease)
  • Liver disease
  • Kidney failure
  • Depression
  • Suicidal tendencies
  • Sleep apnea
  • Substance abuse, or a family history of substance abuse
  • Stomach problems
  • Intestinal infections
  • Difficulty passing urine
  • Enlarged prostate
  • Pancreatitis

Morphine is known to cause dizziness and drowsiness in many patients. People who have taken morphine should not drive, operate heavy machinery or perform any tasks where a lack of alertness could put themselves or others in danger unless they are confident that they can perform these tasks safely and without risk.

Alcohol should be avoided whilst taking morphine.

Before having surgery, make sure that your surgeon is aware that you are currently taking morphine.

If you have any dental treatment whilst receiving morphine treatment, make sure that your dentist is aware of this.

Morphine is known to pass into breast milk if the mother is taking the drug. The drug can be harmful to babies, so it is recommended that patients speak to their doctor before breastfeeding following morphine treatment.

Patients should consult their doctor on the best practices surrounding morphine and pregnancy. Morphine should only be used when strictly necessary during pregnancy as it could potentially cause harm to an unborn baby. Doctors will be able to assess the risks and benefits of morphine and discuss these with patients.

Older people may be more likely to experience some of the side effects of morphine. Older adults are more likely to suffer from confusion, drowsiness, light-headedness, dizziness and breathing problems following treatment with morphine.

Storage

Morphine is usually only administered within a hospital environment and therefore should be subjected to strict rules about the storage of strong and potentially dangerous medication.

Morphine for injecting comes in the form of colorless glass DIM ampoules. These ampoules should be clearly labeled in order to avoid confusion over what they contain. The ampoules are made of colorless glass so that it is easy to see if the contents are discolored or damaged in any way.

Morphine does not need to be refrigerated but should be stored in a location which is not subject to large changes in temperature. The medication should be kept away from moisture, at a temperature below 25°C.

As with all medication, the ampoules should remain in their outer carton to protect them from direct exposure to heat and light. These outer cartons should also be clearly labeled with the name and dosage of the medication house inside so that the morphine can be easily identified and is not confused with any other forms of medication.

Morphine should be stored in a separate place to the needles used to inject it. All needles should be disposed of safely in an official sharps bin and should not be placed with general waste under any circumstances.

Summary

Morphine is a powerful painkiller commonly used to relieve pain in patients who have just received surgery or who have severe conditions. It is a strong drug, which changes the way in which pain is processed within the brain. The strength of the medication means that it comes with the risk of potentially severe side effects. As the drug is almost always administered in a hospital setting, patients can be closely monitored following the use of morphine to ensure that the side effects are kept under control.

Morphine is a potentially addictive substance. The risk of addiction is higher for anyone who has experienced substance abuse disorders in the past and patients who receive particularly high doses or are treated with morphine regularly over a long period of time. Doctors will try to reduce this risk by only prescribing morphine when necessary and in the minimum quantities needed to treat the pain. In the case of patients with histories of substance abuse, other alternatives may be used to prevent the patient from being unnecessarily exposed to narcotics again.

Severe allergic reactions to morphine are rare but can be very severe. Most patients who know that they are allergic to morphine wear an item of medical jewelry to inform any emergency medical services that they cannot have the drug. This is particularly important in the case of morphine, as it is often administered as emergency pain relief following trauma, where the patient might not be able to communicate their allergy to paramedics.