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Acute use (1–3 days) yields a potency about 1.5× stronger than that of morphine and chronic use (7 days+) yields a potency about 2.5 to 5× that of morphine. Similarly, the effect of tramadol increases after consecutive dosing due to the accumulation of its active metabolite and an increase of the oral bioavailability in chronic use.
A 2009 review determined that, when the analyte is morphine and the limit of detection is 1 ng/ml, a 20 mg intravenous (IV) dose of morphine is detectable for 12–24 hours. A limit of detection of 0.6 ng/ml had similar results.
epocrates is a widely used mobile medical reference application that provides healthcare professionals with access to clinical information at the point of care. The software is designed to assist physicians, pharmacists, nurse practitioners, physician assistants and other healthcare providers in making informed decisions about drug interactions, medical calculations, diagnosis and treatment ...
Morphine sulfate pentahydrade (trade names including Dolcontin) has a higher molecular mass than morphine base, and therefore 10 mg morphine sulfate pentahydrate contains approximatively 7.5 mg of morphine free base. [11] Extended-release morphine can be administered together with "rescue doses" of immediate-release morphine pro re nata in case ...
Dose for dose it is roughly ten times more potent than morphine, with 1 mg desomorphine being equivalent 10 mg morphine, via the intravenous (IV) or intramuscular (IM) routes. [ 10 ] Desomorphine is a morphine analogue where the 6-hydroxyl group and the 7,8 double bond have been reduced. [ 8 ]
There are no clinical guidelines outlining the use and implementation of opioid rotation. However, this strategy is commonly used for these various situations: pain not controlled by current opioid, pain controlled but in the presence of intolerable adverse events, pain not controlled despite rapid increase in opioid dose, switching to utilize different alternative routes of administration, or ...
Via the epidural route, a much slower release from epidural space occurs and nicomorphine remains detectable for 1.5 hours or so, and has a longer effect of 18.2 +/- 10.1 hours due to slower release of the active metabolites, morphine and 6-nicotinoylmorphine. Half lives for those compounds is listed in the IV route.
Adverse effects are similar to other opioids and include drowsiness, constipation, vertigo, nausea, vomiting, and respiratory depression. Contraindications include asthma, respiratory insufficiency, and age under 8.