Latest & greatest articles for morphine

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Top results for morphine

1. Is intranasal fentanyl better than parenteral morphine for managing acute pain in children?

Is intranasal fentanyl better than parenteral morphine for managing acute pain in children? BestBets: Is intranasal fentanyl better than parenteral morphine for managing acute pain in children? Is intranasal fentanyl better than parenteral morphine for managing acute pain in children? Report By: Sandeep Rahul Kusre - Senior House Officer Search checked by Jonathan Costello - Consultant A&E Institution: Royal Free Hospital Current web editor: Stewart Teece - Clinical Research Fellow Date (...) Submitted: 5th April 2009 Date Completed: 30th November 2011 Last Modified: 30th November 2011 Status: Green (complete) Three Part Question In [children presenting to Accident & Emergency in acute pain] is [intranasal fentanyl a better analgesic than intravenous or intramuscular morphine] at [reducing pain] Clinical Scenario A child presents to the paediatric emergency department in acute pain but you cannot give him intranasal diamorphine due to both a departmental and nationwide shortage. You are able

2011 BestBETS

2. Morphine In Myocardial Infarction: Delay In Platelet Inhibition Due To Morphine Administered To Patients Presenting With Acute Coronary Syndrome

Morphine In Myocardial Infarction: Delay In Platelet Inhibition Due To Morphine Administered To Patients Presenting With Acute Coronary Syndrome "Morphine In Myocardial Infarction: Delay In Platelet Inhibition Due To" by Stacy R. Joyce < > > > > > Title Author Date of Graduation Summer 8-13-2016 Degree Type Capstone Project Degree Name Master of Science in Physician Assistant Studies First Advisor Jennifer VanAtta Rights . Abstract Background: The American College of Cardiology Foundation (...) /American Heart Association Task Force recommends morphine for patients with ST-elevation myocardial infarction and for patients undergoing primary percutaneous coronary intervention (PPCI). A drug-to-drug interaction between morphine and the preferred antiplatelets have been studied to determine the adverse effects on such a combination in antiplatelets. There is an increase risk of thrombic events if platelets are not effectively inhibited during PPCI. The primary aim of this systematic review

2016 Pacific University EBM Capstone Project

3. Systematic review with meta analysis: In newborns, oral or rectal paracetamol fails to reduce procedural pain, whereas intravenous paracetamol reduces morphine requirements after major surgery

Systematic review with meta analysis: In newborns, oral or rectal paracetamol fails to reduce procedural pain, whereas intravenous paracetamol reduces morphine requirements after major surgery In newborns, oral or rectal paracetamol fails to reduce procedural pain, whereas intravenous paracetamol reduces morphine requirements after major surgery | BMJ Evidence-Based Medicine We use cookies to improve our service and to tailor our content and advertising to you. You can manage your cookie (...) fails to reduce procedural pain, whereas intravenous paracetamol reduces morphine requirements after major surgery Article Text Therapeutics/Prevention Systematic review with meta analysis In newborns, oral or rectal paracetamol fails to reduce procedural pain, whereas intravenous paracetamol reduces morphine requirements after major surgery Christoph Bührer Statistics from Altmetric.com Commentary on: Ohlsson A , Shah PS . Paracetamol (acetaminophen) for prevention or treatment of pain in newborns

2016 Evidence-Based Medicine (Requires free registration)

4. Comparison of Safety and Efficacy of Methadone vs Morphine for Treatment of Neonatal Abstinence Syndrome: A Randomized Clinical Trial

Comparison of Safety and Efficacy of Methadone vs Morphine for Treatment of Neonatal Abstinence Syndrome: A Randomized Clinical Trial Although opioids are used to treat neonatal abstinence syndrome (NAS), the best pharmacologic treatment has not been established.To compare the safety and efficacy of methadone and morphine in NAS.In this randomized, double-blind, intention-to-treat trial, term infants from 8 US newborn units whose mothers received buprenorphine, methadone, or opioids for pain (...) control during pregnancy were eligible. A total of 117 infants were randomized to receive methadone or morphine from February 9, 2014, to March 6, 2017. Mothers who declined randomization could consent to data collection and standard institutional treatment.Infants were assessed with the Finnegan Neonatal Abstinence Scoring System every 4 hours and treated with methadone or placebo every 4 hours or morphine every 4 hours. Infants with persistently elevated Finnegan scores received dose increases

2018 EvidenceUpdates

5. Morphine-6-glucuronide is responsible for the analgesic effect after morphine administration: a quantitative review of morphine, morphine-6-glucuronide, and morphine-3-glucuronide. (PubMed)

Morphine-6-glucuronide is responsible for the analgesic effect after morphine administration: a quantitative review of morphine, morphine-6-glucuronide, and morphine-3-glucuronide. Morphine-6-glucuronide (M6G) is a strong µ-receptor agonist with higher affinity than morphine itself. It has been suggested that M6G contributes to the analgesic effect after administration of morphine, but the extent of its contribution remains unclear.In order to elucidate the relative contribution of both drugs (...) to the overall analgesic effect mediated by the µ-receptor, published data on µ-receptor binding, plasma protein binding, concentrations [preferably area under the concentration-time curve (AUC)] of morphine and M6G in blood or cerebrospinal fluid (CSF), or concentration ratios were used to calculate free CSF concentration corrected for receptor binding for each compound. To compare different routes of administration, free CSF concentrations of M and M6G corrected for potency were added and compared

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2014 British Journal of Anaesthesia

6. Efficacy of Intravenous Paracetamol Versus Intravenous Morphine in Acute Limb Trauma. (PubMed)

Efficacy of Intravenous Paracetamol Versus Intravenous Morphine in Acute Limb Trauma. Efficient pain management is one of the most important components of care in the field of emergency medicine.This study was conducted to compare intravenous paracetamol and intravenous morphine sulfate for acute pain reduction in patients with limb trauma.In a randomized double-blinded clinical trial, all patients (aged 18 years and older) with acute limb trauma and a pain score of greater than 3/10 (...) in the emergency department were recruited; they received either 1 g intravenous paracetamol or 0.1 mg/kg intravenous morphine sulfate over 15 minutes. The primary outcome was the pain score measured on a numerical rating scale at 0, 15 and 30 minutes after commencing drug administration. The requirement for rescue analgesia and the frequency of adverse reactions were also recorded.Sixty patients randomly received either IV paracetamol (n = 30) or IV morphine (n = 30). The mean reduction in numerical rating

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2016 Trauma monthly

7. "Weak" opioid analgesics: codeine, dihydrocodeine and tramadol are no less risky than morphine

"Weak" opioid analgesics: codeine, dihydrocodeine and tramadol are no less risky than morphine Prescrire IN ENGLISH - Spotlight ''"Weak" opioid analgesics: codeine, dihydrocodeine and tramadol are no less risky than morphine'', 1 February 2016 {1} {1} {1} | | > > > "Weak" opioid analgesics: codeine, dihydrocodeine and tramadol are no less risky than morphine Spotlight Every month, the subjects in Prescrire’s Spotlight. 100 most recent :  |   |   |   |    (...) |   |   |   |   |  Spotlight "Weak" opioid analgesics: codeine, dihydrocodeine and tramadol are no less risky than morphine FEATURED REVIEW When opioid therapy is needed, there is no evidence that codeine, dihydrocodeine or tramadol is less risky than morphine at its lowest effective dose. The efficacy of these drugs varies more from one patient to another, and their multiple pharmacokinetic interactions can be difficult to manage. Weak opioids require at least

2016 Prescrire

8. Intranasal fentanyl or diamorphine versus intravenous morphine for analgesia in adults

Intranasal fentanyl or diamorphine versus intravenous morphine for analgesia in adults BestBets: Intranasal fentanyl or diamorphine versus intravenous morphine for analgesia in adults Intranasal fentanyl or diamorphine versus intravenous morphine for analgesia in adults Report By: Lee Helliwell - SpR Emergency Medicine Search checked by Catherine Jackson - ST5, Emergency Medicine Institution: Lancashire Teaching Hospitals NHS Trust Current web editor: Richard Body - Clinical Research Fellow (...) Date Submitted: 8th December 2009 Date Completed: 7th September 2010 Last Modified: 8th September 2010 Status: Green (complete) Three Part Question In [adults presenting to the Emergency Department in pain] is [intranasal fentanyl superior to intravenous morphine] at [reducing pain]? Clinical Scenario It is 7:45am and you are just winding down with a coffee before the end of a shift and the doors to the Emergency Department (ED) burst open. Lying on a stretcher is a young, obese lady who

2010 BestBETS

9. Drugs - Morphine Sulphate Oral Solution

Drugs - Morphine Sulphate Oral Solution Morphine Sulphate Oral Solution MOR Drugs October 2006 Page 1 of 3 Drugs PRESENTATION 5ml unit dose vials containing morphine sulphate 10 milligrams in 5ml (2 milligrams in 1ml). ACTIONS Morphine is a strong opioid analgesic drug for oral administration for pain relief. It is particularly useful for treating severe continuous pain of visceral or soft tissue origins. Morphine produces sedation, euphoria and analgesia; it may both depress respiration (...) and induce hypotension. Histamine is released following morphine administration, this may contribute to its vasodilatory effects and it may also cause bronchoconstriction. INDICATIONS Severe pain. The decision about which analgesia and which route should be guided by clinical judgement (see adult and child pain management guidelines). CONTRA-INDICATIONS Do NOT give oral morphine in the following circumstances: Unable to swallow or protect own airway. Cardiac pain – use intravenous morphine. Children

2007 Joint Royal Colleges Ambulance Liaison Committee

10. Morphine and Ketamine Is Superior to Morphine Alone for Out-of-Hospital Trauma Analgesia: A Randomized Controlled Trial (PubMed)

Morphine and Ketamine Is Superior to Morphine Alone for Out-of-Hospital Trauma Analgesia: A Randomized Controlled Trial We assess the efficacy of intravenous ketamine compared with intravenous morphine in reducing pain in adults with significant out-of-hospital traumatic pain.This study was an out-of-hospital, prospective, randomized, controlled, open-label study. Patients with trauma and a verbal pain score of greater than 5 after 5 mg intravenous morphine were eligible for enrollment (...) . Patients allocated to the ketamine group received a bolus of 10 or 20 mg, followed by 10 mg every 3 minutes thereafter. Patients allocated to the morphine alone group received 5 mg intravenously every 5 minutes until pain free. Pain scores were measured at baseline and at hospital arrival.A total of 135 patients were enrolled between December 2007 and July 2010. There were no differences between the groups at baseline. After the initial 5-mg dose of intravenous morphine, patients allocated to ketamine

2012 EvidenceUpdates

11. Morphine for chronic neuropathic pain in adults. (PubMed)

Morphine for chronic neuropathic pain in adults. Neuropathic pain, which is caused by a lesion or disease affecting the somatosensory system, may be central or peripheral in origin. Neuropathic pain often includes symptoms such as burning or shooting sensations, abnormal sensitivity to normally painless stimuli, or an increased sensitivity to normally painful stimuli. Neuropathic pain is a common symptom in many diseases of the nervous system. Opioid drugs, including morphine, are commonly used (...) to treat neuropathic pain. Most reviews have examined all opioids together. This review sought evidence specifically for morphine; other opioids are considered in separate reviews.To assess the analgesic efficacy and adverse events of morphine for chronic neuropathic pain in adults.We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, and Embase for randomised controlled trials from inception to February 2017. We also searched the reference lists of retrieved studies

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2017 Cochrane

12. Impact of morphine, fentanyl, oxycodone or codeine on patient consciousness, appetite and thirst when used to treat cancer pain. (PubMed)

Impact of morphine, fentanyl, oxycodone or codeine on patient consciousness, appetite and thirst when used to treat cancer pain. There is increasing focus on providing high quality care for people at the end of life, irrespective of disease or cause, and in all settings. In the last ten years the use of care pathways to aid those treating patients at the end of life has become common worldwide. The use of the Liverpool Care Pathway in the UK has been criticised. In England the LCP (...) to an earlier death, and that effects of opioids on appetite and thirst may result in unnecessary suffering. This rapid review, commissioned by the National Institute for Health Research, used standard Cochrane methodology to examine adverse effects of morphine, fentanyl, oxycodone, and codeine in cancer pain studies as a close approximation to possible effects in the dying patient.To determine the impact of opioid treatment on patient consciousness, appetite and thirst in randomised controlled trials

2014 Cochrane

13. Morphine vs Methadone Treatment for Infants with Neonatal Abstinence Syndrome. (PubMed)

Morphine vs Methadone Treatment for Infants with Neonatal Abstinence Syndrome. To estimate the relationship of initial pharmacotherapy with methadone or morphine and length of stay (LOS) in infants with neonatal abstinence syndrome (NAS) admitted to the neonatal intensive care unit (NICU).From the Pediatrix Clinical Data Warehouse database, we identified all infants born at ≥36 weeks of gestation between 2011 and 2015 who were diagnosed with NAS (International Classification of Diseases, Ninth (...) Revision code 779.5) and treated with methadone or morphine in the first 7 days of life. We used multivariable Cox proportional hazards regression analysis to quantify the association between initial treatment and LOS after adjusting for maternal age, maternal race/ethnicity, maternal drug use, maternal smoking, gestational age, small for gestational age status, inborn status, and discharge year.We identified a total of 7667 eligible infants, including 1187 treated with methadone (15%) and 6480 treated

2018 Journal of Pediatrics

14. Morphine for Treatment of Dyspnea in Patients With COPD

Morphine for Treatment of Dyspnea in Patients With COPD Morphine for Treatment of Dyspnea in Patients With COPD - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Morphine for Treatment of Dyspnea in Patients (...) Collaborator: ZonMw: The Netherlands Organisation for Health Research and Development Information provided by (Responsible Party): Maastricht University Medical Center Study Details Study Description Go to Brief Summary: Dyspnea is the most reported symptom of patients with advanced Chronic Obstructive Pulmonary Disease (COPD) and is undertreated. Morphine is an effective treatment for dyspnea and is recommended in clinical practice guidelines, but questions concerning benefits and concerns about

2015 Clinical Trials

15. Effectiveness of Prehospital Morphine, Fentanyl, and Methoxyflurane in Pediatric Patients. (PubMed)

Effectiveness of Prehospital Morphine, Fentanyl, and Methoxyflurane in Pediatric Patients. To compare the effectiveness of intravenous morphine, intranasal (IN) fentanyl, and inhaled methoxyflurane for managing moderate to severe pain in pediatric patients in the out-of-hospital setting.We conducted a retrospective comparative study of 3,312 pediatric patients aged between 5 and 15 years who had moderate to severe pain (pain score ≥ 5) and who received intravenous morphine, IN fentanyl (...) analgesic agents were effective in the majority of patients (87.5%, 89.5%, and 78.3% for morphine, fentanyl, and methoxyflurane, respectively). There was evidence that methoxyflurane was less effective than both morphine (odds ratio [OR] 0.52; 95% confidence interval [CI] 0.36-0.74) and fentanyl (OR 0.43; 95% CI 0.29-0.62; p < 0.0001). There was no clinical or statistical evidence of difference in the effectiveness of fentanyl and morphine in this population (OR 1.22; 95% CI 0.74-2.01

2011 Prehospital emergency care

16. How should conversion from oral morphine to fentanyl patches be carried out?

How should conversion from oral morphine to fentanyl patches be carried out? How should conversion from oral morphine to fentanyl patches be carried out? – SPS - Specialist Pharmacy Service – The first stop for professional medicines advice Menu · · 19th December 2017 This updated Medicines Q&A considers the factors which need to be considered when converting patients from oral morphine to fentanyl patches. Explicit guidance on switching opioids is difficult because both the reasons (...) for switching and the patient’s circumstances differ. When initiating transdermal fentanyl in a patient currently treated with oral morphine, the initial dose should be based upon their previous 24-hour opioid requirement. Two parallel dosage conversion ratios are currently recommended by most manufacturers of fentanyl patches. Data from two small studies has shown that conversion of oral morphine to transdermal fentanyl with a ratio of 100:1 is safe and effective. This ratio is endorsed by the Palliative

2018 Specialist Pharmacy Services

17. The efficacy and safety of morphine for analgesia in patients with presumed ischaemic acute cardiac chest pain: a systematic review and meta-analysis

The efficacy and safety of morphine for analgesia in patients with presumed ischaemic acute cardiac chest pain: a systematic review and meta-analysis Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email salutation (e.g. "Dr Smith

2017 PROSPERO

18. Acupuncture Versus Intravenous Morphine in the Management of Acute Pain in the Emergency Department

Acupuncture Versus Intravenous Morphine in the Management of Acute Pain in the Emergency Department Acupuncture Versus Intravenous Morphine in the Management of Acute Pain in the Emergency Department - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please (...) remove one or more studies before adding more. Acupuncture Versus Intravenous Morphine in the Management of Acute Pain in the Emergency Department (AcuMAP) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT02460913 Recruitment Status : Completed First Posted : June 3, 2015 Last Update Posted : June 9

2015 Clinical Trials

19. Parecoxib Supplementation to Morphine Analgesia Decreases Incidence of Delirium in Elderly Patients After Hip or Knee Replacement Surgery: A Randomized Controlled Trial

Parecoxib Supplementation to Morphine Analgesia Decreases Incidence of Delirium in Elderly Patients After Hip or Knee Replacement Surgery: A Randomized Controlled Trial Severe pain and high-dose opioids are both associated with increased risk of postoperative delirium. The authors investigated whether parecoxib-supplemented IV morphine analgesia could decrease the incidence of delirium in elderly patients after total hip or knee replacement surgery.In a randomized, double-blind, 2-center trial (...) , patients of 60 years or older who underwent elective total hip or knee replacement surgery were assigned in a 1:1 ratio to receive either parecoxib (40 mg at the end of surgery and then every 12 hours for 3 days) or placebo (normal saline). All patients received combined spinal-epidural anesthesia during surgery and IV morphine for postoperative analgesia. The primary outcome was the incidence of delirium within 5 days after surgery.Between January 2011 and May 2013, 620 patients were enrolled and were

2017 EvidenceUpdates

20. Meta-Analysis of the Ease of Care From the Nurses' Perspective Comparing Fentanyl Iontophoretic Transdermal System (ITS) Vs Morphine Intravenous Patient-Controlled Analgesia (IV PCA) in Postoperative Pain Management. (PubMed)

Meta-Analysis of the Ease of Care From the Nurses' Perspective Comparing Fentanyl Iontophoretic Transdermal System (ITS) Vs Morphine Intravenous Patient-Controlled Analgesia (IV PCA) in Postoperative Pain Management. The aim of this meta-analysis was to compare the ease of care (EOC) of fentanyl iontophoretic transdermal system (ITS) vs the morphine intravenous patient-controlled analgesia (IV PCA) as assessed by the nurse.Meta-analysis of three phase 3B randomized active-comparator trials.This (...) meta-analysis according to Cochrane's approach assessed EOC using a validated nurse questionnaire (22 items grouped into three subscales, which include time efficiency, convenience, and satisfaction) in adult patients treated with fentanyl ITS or morphine IV PCA for postoperative pain management. The weighted mean difference (WMD) between treatments was calculated.EOC analyses were based on responses to questionnaires from 848 (fentanyl ITS) and 761 (morphine IV PCA) nurses. Fentanyl ITS

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2017 Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses