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American Journal of Hospital Pharmacy Mar 1984The effect of morphine sulfate concentration on flow rate in an implantable pump was studied. Solutions containing morphine sulfate 5 mg/3 ml, 10 mg/3 ml, 20 mg/3 ml,...
The effect of morphine sulfate concentration on flow rate in an implantable pump was studied. Solutions containing morphine sulfate 5 mg/3 ml, 10 mg/3 ml, 20 mg/3 ml, and 200 mg/3 ml were prepared from morphine sulfate powder; a solution containing morphine sulfate 20 mg/3 ml with bupivacaine hydrochloride 0.125% was also prepared. Sterile water was used for preparing the morphine solutions and as the control solution. A model 400 Infusaid pump was filled with 50 ml of the drug solution, placed in a water bath at 37 degrees C, and allowed to equilibrate for three hours. Samples of each concentration of morphine solution and control solution were then collected in an analytical graduate over 20-hour periods. Between each collection period, the pump was flushed twice with sterile water. Five samples of each morphine solution and control solution were collected. The osmolality of one sample of each solution was determined to assess drug concentration indirectly; morphine sulfate concentrations were not actually measured. Actual solution volumes collected during the 20-hour collection periods were corrected to 24 hours to allow comparison with the pump's preset daily flow rate. Collection volumes and calculated daily flow rates decreased with increasing morphine sulfate concentrations and solution osmolalities; a significant positive correlation between osmolality and assumed drug concentration was found. The flow rate of the solution containing morphine 200 mg/3 ml was approximately equal to the pump's stated flow rate; flow rates for all other solutions were higher than the stated flow rate.(ABSTRACT TRUNCATED AT 250 WORDS)
Topics: Infusions, Parenteral; Morphine; Osmolar Concentration
PubMed: 6702855
DOI: No ID Found -
Journal of Analytical Toxicology Mar 2002The objective of this study was to determine if the administration of poppy seeds to horses would result in detectable concentrations of morphine in urine and blood...
The objective of this study was to determine if the administration of poppy seeds to horses would result in detectable concentrations of morphine in urine and blood samples, as has been shown to occur in humans. In this study blood and urine samples were collected following administration of poppy seeds and morphine sulfate orally to four horses. Urine samples were subjected to enzyme-linked immunosorbent assay (ELISA) for the presence of morphine. All urine samples testing positive by ELISA, as well as plasma samples collected after administration of the 10-g doses of poppy seeds, were analyzed by gas chromatography-mass spectrometry for the presence of morphine. Morphine was detectable in the plasma samples for at least 4 h after administration of 10 g of poppy seeds. Morphine was detectable in urine samples for up to 24 h after administration of 10 g, 5 g, and 1 g of poppy seeds and 426.7 microg of morphine as morphine sulfate. The results of this study indicate that horses that consume or are administered poppy seeds may have detectable concentrations of morphine in their urine and plasma for hours after administration.
Topics: Administration, Oral; Animals; Dose-Response Relationship, Drug; Enzyme-Linked Immunosorbent Assay; Female; Gas Chromatography-Mass Spectrometry; Horses; Morphine; Papaver; Seeds; Substance Abuse Detection
PubMed: 11916019
DOI: 10.1093/jat/26.2.81 -
Critical Care Medicine Oct 1984After cardiac surgery, 44 children received a continuous iv infusion of morphine sulfate at 10 to 30 micrograms/kg X h. During weaning from assisted ventilation and...
After cardiac surgery, 44 children received a continuous iv infusion of morphine sulfate at 10 to 30 micrograms/kg X h. During weaning from assisted ventilation and during spontaneous ventilation serum morphine levels less than 30 ng/ml were not associated with elevated PaCO2. Five extubated patients breathed spontaneously, and 35 patients were weaned from assisted to spontaneous ventilation with normal PaCO2 while receiving morphine by infusion, indicating that morphine did not interfere with spontaneous ventilation. In 12 older children who gave verbal pain scores, pain was relieved at serum morphine levels above 12 ng/ml.
Topics: Adolescent; Carbon Dioxide; Cardiac Surgical Procedures; Child; Child, Preschool; Dose-Response Relationship, Drug; Humans; Hydrogen-Ion Concentration; Infant; Infusions, Parenteral; Morphine; Pain, Postoperative; Respiration, Artificial
PubMed: 6435955
DOI: 10.1097/00003246-198410000-00005 -
American Journal of Diseases of... Aug 1992To determine how early in childhood the clearance of morphine sulfate reaches that in adults.
OBJECTIVE
To determine how early in childhood the clearance of morphine sulfate reaches that in adults.
DESIGN
Patient series.
SETTING
Children's Hospital and Medical Center, Seattle, Wash.
PARTICIPANTS
Forty-nine children aged 1 day to 2.5 years with normal renal and hepatic function. All children were receiving a constant rate intravenous infusion of morphine for postoperative analgesia for greater than 24 hours.
INTERVENTIONS
Blood and urine samples were collected during infusion and immediately after discontinuation of the morphine infusion.
MEASUREMENTS
Morphine concentrations were determined and clearance was calculated using the infusion data. Half-life and volume of distribution were calculated using the postinfusion data. The formation of metabolites was evaluated using the urine data. Morphine clearance increased with age, median clearances ranging from 5 mL/kg per minute in neonates aged 1 to 7 days to 21 mL/kg per minute in infants aged 6 months and older. This change in clearance correlated with age. The formation clearance of morphine glucuronide was correlated with age, whereas the formation clearance of morphine sulfate and the renal clearance of morphine were independent of age.
CONCLUSIONS
Morphine clearance reaches adult values by age 6 months to 2.5 years. In contrast to previous reports on the maturation of sulfate conjugation, it does not appear that morphine sulfate clearance is enhanced relative to glucuronidation in early infancy.
Topics: Analgesia; Child, Preschool; Glucuronates; Humans; Infant; Infant, Newborn; Kidney; Metabolic Clearance Rate; Morphine; Postoperative Care; Sulfates; Time Factors
PubMed: 1636668
DOI: 10.1001/archpedi.1992.02160200094036 -
American Journal of Hospital Pharmacy Sep 1990The stability of various concentrations of morphine sulfate solution stored in Cormed III (Kalex) i.v. bags at two temperatures was investigated. Solutions of morphine...
The stability of various concentrations of morphine sulfate solution stored in Cormed III (Kalex) i.v. bags at two temperatures was investigated. Solutions of morphine sulfate 0.5, 15, 30, and 60 mg/mL were prepared under a horizontal-laminar-airflow hood with 0.9% sodium chloride solution and placed into 100-mL Kalex bags. Two bags were prepared for each concentration; one was stored at 5 degrees C and the other at 37 degrees C. Samples were analyzed in triplicate by high-performance liquid chromatography on days 0, 2, 5, 9, and 14. All morphine sulfate solutions were stable for 14 days at 37 degrees C, and the 0.5-, 15-, and 30-mg/mL solutions were stable for 14 days at 5 degrees C. However, the 60-mg/mL solution stored at 5 degrees C was found to contain 57% of the actual initial concentration on day 9 and 51% on day 14; the decrease coincided with the appearance of a white precipitate. Beginning on day 5, all the solutions displayed a light brown color that darkened as the study proceeded. This qualitative change was not associated with any change in morphine concentration. Solutions of morphine sulfate 0.5 to 60 mg/mL stored at 5 or 37 degrees C were stable for 14 days in Kalex bags, except for 60-mg/mL solutions stored at 5 degrees C for nine days or longer.
Topics: Chromatography, High Pressure Liquid; Drug Packaging; Drug Stability; Infusions, Intravenous; Morphine; Temperature
PubMed: 2220859
DOI: No ID Found -
American Journal of Veterinary Research Jan 2007To assess the pharmacokinetics and pharmacodynamics of morphine in llamas.
OBJECTIVE
To assess the pharmacokinetics and pharmacodynamics of morphine in llamas.
ANIMALS
6 healthy adult llamas.
PROCEDURES
Llamas received morphine sulfate in a randomized crossover design. In phase 1, they received IV or IM administration of morphine at 0.05 or 0.5 mg/kg, respectively; in phase 2, they received IV administration of morphine at 0.05, 0.25, or 0.5 mg/kg. Plasma morphine and morphine-6-glucuronide concentrations were determined by validated methods. Body temperature, heart rate, respiratory rate, sedation, and analgesia were assessed and compared with plasma concentrations by regression analysis.
RESULTS
Total body clearance was similar between IV administration of morphine sulfate at 0.25 and 0.5 mg/kg (mean +/- SD, 25.3 +/- 6.9 mL/min/kg and 27.3 +/- 5.9 mL/min/kg, respectively), and linearity was demonstrated between these doses. Bioavailability of morphine following IM administration at 0.5 mg/kg was 120 +/- 30%. Body temperature and sedation increased as the dose of morphine administered increased. Heart rate was unaffected by varying doses. Respiratory rate decreased as dose increased. Analgesia was difficult to assess as a result of high individual variability. Intravenous administration of morphine at 0.25 mg/kg provided the most consistent increase in tolerance to electric stimulation. Pharmacodynamic modeling revealed a sigmoidal relationship between plasma concentration and sedation score.
CONCLUSIONS AND CLINICAL RELEVANCE
Morphine was characterized by a large apparent volume of distribution and high systemic clearance in llamas. A prolonged half-life was observed with IM injection. Intravenous administration of morphine sulfate at 0.25 mg/kg every 4 hours is suggested for further study.
Topics: Analgesia; Analgesics, Opioid; Animals; Body Temperature; Camelids, New World; Cross-Over Studies; Female; Heart Rate; Injections, Intramuscular; Injections, Intravenous; Male; Morphine; Morphine Derivatives; Random Allocation; Respiration
PubMed: 17199415
DOI: 10.2460/ajvr.68.1.25 -
Anesthesia and Analgesia Apr 2002Recent advances in acute pain mechanisms and management have implicated the N-methyl D-aspartate receptor-ion channel complex in the development of postoperative...
UNLABELLED
Recent advances in acute pain mechanisms and management have implicated the N-methyl D-aspartate receptor-ion channel complex in the development of postoperative hyperalgesia and acute opioid tolerance. N-methyl D-aspartate receptor antagonists such as ketamine have been used increasingly in clinical studies in an effort to minimize acute postoperative pain and reduce opioid requirements. A mixture of ketamine and an opioid administered in the same solution and syringe would be a practical and useful technique for postoperative epidural analgesia, continuous IV infusion, or patient-controlled IV analgesia. We investigated the stability of a morphine sulfate and racemic ketamine solution in saline at pH 5.5-7.5 over a period of 4 days. Our study demonstrates that the ketamine-morphine mixture at a clinically relevant concentration seems to be stable at room temperature, at a wide range of pH values, for at least 4 days.
IMPLICATIONS
Small-dose ketamine is used with increasing frequency in the acute postoperative setting as an adjunct to traditional opioid analgesics. We show that a racemic ketamine and morphine solution at a clinically relevant concentration seems to be stable at room temperature at a wide range of pH values for at least 4 days.
Topics: Analgesics; Analgesics, Opioid; Chromatography, High Pressure Liquid; Drug Combinations; Drug Stability; Drug Storage; Hydrogen-Ion Concentration; Ketamine; Morphine; Solutions
PubMed: 11916793
DOI: 10.1097/00000539-200204000-00023 -
Ai Zheng = Aizheng = Chinese Journal of... Dec 2007Morphine sulfate controlled-released tablet and morphine hydrochloride sustained-released tablet are preferred medicines for treating moderate-severe cancer pain. There... (Comparative Study)
Comparative Study Randomized Controlled Trial
BACKGROUND & OBJECTIVE
Morphine sulfate controlled-released tablet and morphine hydrochloride sustained-released tablet are preferred medicines for treating moderate-severe cancer pain. There are some differences between the two medicines in their efficacy, metabolism and adverse events. This study was to compare the efficacy and toxicities between morphine sulfate controlled-released tablet and morphine hydrochloride sustained-released tablet in treating moderate-severe cancer pain.
METHODS
A total of 121 patients with moderate-severe cancer pain were randomized into two groups: 61 were treated with morphine sulfate controlled-released tablet and 60 were treated with morphine hydrochloride sustained-released tablet. Analgesic efficacy and toxicities of the two medicines were observed.
RESULTS
Of the 61 patients treated with morphine sulfate controlled-released tablet, 12 had moderate pain, 49 had severe pain; the total response rate was 91.80%. Of the 60 patients treated with morphine hydrochloride sustained-released tablet, 13 had moderate pain, 47 had severe pain; the total response rate was 91.67%. There was no significant difference in the efficacy between the two medicines. Digestive system adverse events, including nausea, vomiting and constipation, were more common in morphine hydrochloride sustained-released tablet group than in morphine sulfate controlled-released tablet group (66.66% vs. 34.43%, P<0.05).
CONCLUSIONS
Both morphine sulfate controlled-released tablet and morphine hydrochloride sustained-released tablet are safety in treating moderate-severe cancer pain and the toxicities are tolerable. We recommend to take morphine sulfate controlled-released tablet for older patients and the patients with digestive disorders.
Topics: Adolescent; Adult; Aged; Analgesics, Opioid; Constipation; Delayed-Action Preparations; Female; Humans; Male; Middle Aged; Morphine; Nausea; Neoplasms; Pain; Pain Measurement; Treatment Outcome; Vomiting; Young Adult
PubMed: 18076801
DOI: No ID Found -
The Journal of Pharmacology and... Aug 1980A study was designed to determine the effects of morphine sulfate on small intestinal propulsion and small intestinal myoelectric activity in conscious rats. Adult male...
A study was designed to determine the effects of morphine sulfate on small intestinal propulsion and small intestinal myoelectric activity in conscious rats. Adult male rats were divided into two groups. Each member of one group was implanted with an indwelling catheter in the proximal duodenum. Each member of the other group was implanted with electrodes on the serosal surface of the proximal small bowel. Intestinal transit was determined by administering a bolus of radioactive chromium (Na2 51CrO4, 0.5 muCi) in 0.2 ml of saline via the catheter and following its progression through the small intestine. In fasted rats, morphine sulfate administered s.c. inhibited intestinal transit of 51Cr in a dose-dependent manner between 1 and 25 mg/kg. Intestinal motility was determined by monitoring intestinal myoelectric activity both before and after administration of morphine sulfate. In fasted rats, s.c. administration of morphine caused an inhibition of spike potential activity. The inhibition was dose-dependent between dosages of 1 and 25 kg/kg. We conclude that morphine sulfate causes a dose-dependent inhibition of intestinal transit in fasted rats and that this inhibition is correlated with a dose-dependent inhibition of spike potentials of the intestinal smooth muscle cells.
Topics: Action Potentials; Animals; Chromium Radioisotopes; Dose-Response Relationship, Drug; Electromyography; Gastrointestinal Motility; Intestine, Small; Male; Morphine; Muscle, Smooth; Rats
PubMed: 7391981
DOI: No ID Found -
American Journal of Hospital Pharmacy Jul 1990
Topics: Chemistry, Pharmaceutical; Humans; Infusions, Intravenous; Morphine
PubMed: 2098002
DOI: No ID Found