Scribd Logo
Upload

Welcome to Scribd!

  • 50 views

    Mir & MCR

    Uploaded by

    Mhmoud Nabeh
    Morphine immediate-release (MIR) and sustained-release (MSR) are centrally acting opioid analgesics used to treat severe pain, especially cancer pain. MIR is available as tablets and oral solution while MSR is available as capsules or tablets. The dosage of MSR is based on the effective daily dose determined during initial treatment with MIR, with the daily dose remaining the same. Common adverse effects include sedation, respiratory depression, nausea, vomiting and constipation. Morphine should be administered cautiously in patients with respiratory or hepatic impairment and discontinued gradually to avoid withdrawal symptoms.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Mir & MCR

    Uploaded by

    Mhmoud Nabeh
    50 views1 page
    Morphine immediate-release (MIR) and sustained-release (MSR) are centrally acting opioid analgesics used to treat severe pain, especially cancer pain. MIR is available as tablets and oral solution while MSR is available as capsules or tablets. The dosage of MSR is based on the effective daily dose determined during initial treatment with MIR, with the daily dose remaining the same. Common adverse effects include sedation, respiratory depression, nausea, vomiting and constipation. Morphine should be administered cautiously in patients with respiratory or hepatic impairment and discontinued gradually to avoid withdrawal symptoms.

    Original Title

    MIR & MCR

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Morphine immediate-release (MIR) and sustained-release (MSR) are centrally acting opioid analgesics used to treat severe pain, especially cancer pain. MIR is available as tablets and oral solution while MSR is available as capsules or tablets. The dosage of MSR is based on the effective daily dose determined during initial treatment with MIR, with the daily dose remaining the same. Common adverse effects include sedation, respiratory depression, nausea, vomiting and constipation. Morphine should be administered cautiously in patients with respiratory or hepatic impairment and discontinued gradually to avoid withdrawal symptoms.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    50 views1 page

    Mir & MCR

    Uploaded by

    Mhmoud Nabeh
    Morphine immediate-release (MIR) and sustained-release (MSR) are centrally acting opioid analgesics used to treat severe pain, especially cancer pain. MIR is available as tablets and oral solution while MSR is available as capsules or tablets. The dosage of MSR is based on the effective daily dose determined during initial treatment with MIR, with the daily dose remaining the same. Common adverse effects include sedation, respiratory depression, nausea, vomiting and constipation. Morphine should be administered cautiously in patients with respiratory or hepatic impairment and discontinued gradually to avoid withdrawal symptoms.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    MORPHINE immediate-release (MIR) oral MORPHINE sustained-release (MSR) oral

    Therapeutic action Centrally acting opioid analgesic Centrally acting opioid analgesic
    Indications Severe pain Severe and persistent pain, especially cancer pain
    Forms and • 15 mg immediate-release tablet • 10 mg, 30 mg and 60 mg sustained-release
    strengths • 10 mg/5 ml oral solution, for pediatric use capsules or tablets
    • Usually, the effective daily dose is determined during
    the initial treatment with immediate-release morphine
    (MIR). When the changing from MIR to MSR, the
    daily dose remains the same.
    For example, if effective dose of MIR is 20 mg every
    4 hours (120 mg daily), the dose of MSR is 60 mg
    There is no standard dose. The optimal dose is every 12 hours (120 mg daily).
    that which provides efficient pain relief to the • If treatment is initiated directly with MSR:
    Dosage patient. It is adjusted in relation to the regular o Child over 6 months: initially 0.5 mg/kg every 12
    assessment of pain intensity and the incidence of hours
    adverse effects. o Adult: initially 30 mg every 12 hours
    • Patients stabilized on MSR may require rescue
    doses of MIR in the event of episodic (breakthrough)
    pain. A rescue dose corresponds to 10% of the daily
    MSR dose. If a patient regularly requires more than 3
    rescue doses per day, increase the daily MSR dose
    by the sum of rescue doses.
    According to clinical response. Do not stop long-term
    Once the pain is controlled, change to sustained-
    Duration release morphine.
    treatment abruptly. Decrease doses progressively to
    avoid withdrawal symptoms.
    • Do not administer to patients with severe respiratory impairment or decompensated hepatic impairment.
    • Do not initiate treatment with the sustained-release formulation in elderly patients or those with renal or hepatic
    impairment. Begin treatment with the immediate release formulation (MIR).
    • May cause:
    o dose-related sedation and respiratory depression, nausea, vomiting, constipation, urinary retention,
    confusion, raised intracranial pressure, pruritus;
    o in the event of overdose: excessive sedation, respiratory depression, coma.
    • Management of respiratory depression includes assisted ventilation and/or administration of naloxone. Monitor
    Contra-indications, patient closely for several hours.
    adverse effects, • Administer with caution to patients with respiratory impairment, head injury, raised intracranial pressure,
    uncontrolled epilepsy or urethroprostatic disorders.
    precautions
    • Do not combine with opioid analgesics with mixed agonist-antagonist activity such as buprenorphine,
    nalbuphine, pentazocine (competitive action).
    • Increased risk of sedation and respiratory depression, when combined with alcohol and drugs acting on the
    central nervous system: benzodiazepines (diazepam, etc.), neuroleptics (chlorpromazine, haloperidol, etc.),
    antihistamines (chlorphenamine, promethazine), phenobarbital, etc.
    • Pregnancy and breast-feeding: no contra-indication. The child may develop withdrawal symptoms, respiratory
    depression and drowsiness when the mother receives morphine at the end of the 3 rd trimester and during
    breast-feeding. In these situations, administer with caution, for a short period, at the lowest effective dose, and
    monitor the child.
    • Administer an appropriate laxative (e.g., lactulose)
    if analgesic treatment continues more than 48 • Administer an appropriate laxative (e.g. lactulose) if
    hours. analgesic treatment continues more than 48 hours.
    • The morphine dose in tablets is not suitable for • Do not crush or chew capsules. They can be
    Remarks young children. Use oral solution instead. If this is opened and emptied into food.
    not available, use injectable morphine by the oral • Morphine is on the list of narcotics: follow national
    route: dilute an ampoule of 10 mg/ml (1 ml) with 9 regulations.
    ml of water to obtain a solution containing 1 mg/ml.
    • Morphine is on the list of narcotics: follow national
    regulations.

    Storage Below 25 °C Below 25 °C

    You might also like