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PO: oral • IV: intravenous injection • IM: intramuscular injection • SC: subcutaneous injection • SL: sublingual • TD: transdermal "Strength" is defined as analgesic potency relative to oral morphine. Tolerance, sensitization, cross-tolerance, metabolism, and hyperalgesia may be complex factors in some individuals.
Hydromorphone 2 mg IV is equivalent to approximately 10 mg morphine IV. [9] Hydromorphone was patented in 1923. [12] Hydromorphone is made from morphine. [13] It is on the World Health Organization's List of Essential Medicines. [14] It is available as a generic medication. [7]
While oral morphine has a general bioavailability range is only 20-40%, properly administered rectal use of liquid morphine has an effective bioavailability of roughly 70%, or more than double the overall potency of oral morphine and more than two thirds that of IV use. Swallowing tends to be the safest and slowest method of ingesting drugs.
The most common conversion ratio, given on equianalgesia charts used in the United States, Canada, the UK, Republic of Ireland, the European Union, Russia and elsewhere as 130 mg IM equals 200 mg PO—both of which are equivalent to 10 mg of morphine sulphate IV and 60 mg of morphine sulphate PO.
Morphine pharmaceuticals are subject to annual manufacturing quotas; in 2017 these quotas were 35.0 tonnes of production for sale, and 27.3 tonnes of production as an intermediate, or chemical precursor, for conversion into other drugs. [154] Morphine produced for use in extremely dilute formulations is excluded from the manufacturing quota.
The opioid epidemic took hold in the U.S. in the 1990s. Percocet, OxyContin and Opana became commonplace wherever chronic pain met a chronic lack of access to quality health care, especially in Appalachia. The Centers for Disease Control and Prevention calls the prescription opioid epidemic the worst of its kind in U.S. history.
According to a Cochrane review in 2013, extended-release morphine as an opioid replacement therapy for people with heroin addiction or dependence confers a possible reduction of opioid use and with fewer depressive symptoms but overall more adverse effects when compared to other forms of long-acting opioids. The length of time in treatment was ...
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