Morphine Affected Me with Low Blood Pressure
91© Duchess O’Blunt, 2009; all rights reserved.
Does Morphine lower blood pressure and heart rate?
Recently I was admitted to hospital in serious pain from a kidney stone. I know, who cares right? I hear you, and I won’t go into it.
Pain relief is a pretty wonderful thing - anyone who has benefited from this will concur I'm sure.
In this particular instance I was administered Morphine for the pain. Twice. I was offered a third dose, which I very ungraciously refused. Pain can do that to a person.
It turns out that my blood pressure and heart rate were affected, they both dropped considerably.
Morphine - a pain reliever
This is not meant to be a dissertation on Morphine, so much as a personal observation. I am simply writing about my experience.
Morphine was injected as a means of pain relief and provided almost immediate relief. I understand that it dulls the pain perception center in the brain and generally takes about 10 minutes to kick in and provides about 2 to 3 hours of relief. After 10 minutes, I found it did dull the pain enough for me to grin and bear it.
Morphine belongs to a group of drugs called narcotic pain relievers which also include:
- Codeine
- Methadone
- Oxycontin
- Darvocet
- Percocet
- Vicodine
- Lortab
I'm told this is THE manual for these questions (see comments by Tucci78)
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Morphine, be aware
I was administered morphine intravenously after being admitted, and as far as I know, that was a first for me. After the second dose I refused any more. I figured, if it was going to work, it would have done so by now. Not that I have any clue the size of the dose, or anything else for that matter - I just wasn't thrilled about having any more. I'm allergic to pain, so the first two doses, I was hoping would do the trick. But heck, I've had babies, so this couldn't be THAT bad.
This is one of the reasons why answering the questions put to you at triage truthfully is so important. These are professionals and they have to ask you these questions. Be thankful, because in some extreme cases it could very well be life or death.
For example, you should not be administered Morphine as a pain reliever if you have these or other symptoms:
- asthma, sleep apnea or other breathing disorders
- liver or kidney disease
- an under active thyroid
- epilepsy
- low blood pressure
- gallbladder disease
Medical Information
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Side effects and precautions
You may not have any of these side effects, but on the other hand you may experience more than one. As with most medications that have been proven to be addictive, these side effects may diminish with continued use.
Some common side effects:
- Nausea and vomiting
- Sleepiness
- Constipation
- Dizziness
-
Light-headedness
Some less common side effects:
- Stomach cramps
- Headache
- Dry mouth
- Loss of appetite
- Slow heartbeat
- Low blood pressure
Slowed breathing and low blood pressure can occur if the dose is too high. Medical attention should be sought immediately if you feel extremely tired, lightheaded, dizzy, sweaty or short of breath.
Allergic reactions are not common but can cause a tightening of the chest, swelling, wheezing, fever, itching, blue skin color or a cough. Immediate medical attention is required. Source
Dependence or addiction
Long term use can develop a “tolerance” meaning more is required to provide the same effect. This can often happen if the medication is administered for cancer patience for example. Addiction is a psychological problem that occurs when morphine is used to provide a euphoric experience and not as a pain medication. It can be addictive and should never be administered personally.
To find out more information on addiction, withdrawal and signs of overdose click here.
Low Blood Pressure and a Lower Heart Rate
I do not advocate drug abuse in any form, and that is not my reason for writing this Hub. After my brief journey through pain, the nurse taking my blood pressure and heart rate mentioned they were very low, that I must be an athlete. One look at me and it's easy to determine I'm not. I jokingly mentioned it must be the drugs. When I started to think about, I decided I needed to know. I wanted these particular questions answered. Therefore, the research.
It seems that I am affected with some of the less common side effects. This research has provided that answer for me, perhaps it will give you an awareness as well.
Here's hoping you don't ever need it.
Health Care Professionals - A Thankless Job
- Health Care Professionals - A Thankless Job
So, here we are 6:00 am Thanksgiving morning, and I wake my husband to tell him he has to take me to the hospital. I seldom visit the Doctor let alone ask to be taken to the hospital. So, instant panic...
Ways to Lower Blood Pressure
This does not appear to be a valid RSS feed.DISCLAIMER
This Hub does not provide any medical diagnosis, symptom assessment, health counseling or medical opinion for individual users.
Any links provided - Those organizations are solely responsible for what information they post. Any information (including the right to display such information) found on their respective Web sites is their sole responsibility. If you are feeling ill or require medical attention please call your doctor or visit your closest hospital.
Family Health History
- How to create an accurate health history
A family health history is a documented history of health problems that have occurred in your biological family that may affect your health. Your doctor can use your health history to see if you are at risk for certain disorders and diseases.
Is The Patient Responsible For Knowing What Works?
I have updated this piece with an excerpt from one of the comments from Tucci78, because it raises a question for me that I had not thought of. Are we as a patient, responsible for what is prescribed or administered to us at the hospitals?
"There's a LOT of stuff online, much of it written for nursing students who have to tackle this subject at the undergraduate level (no precedent training in organic chemistry and biochemistry, for example), and come at things with a very practical and very effective "nuts-and-bolts" approach. You would certainly find it well within your grasp, I assure you. . . The patient has himself a duty in the clinical relationship, and part of that duty involves the acquisition of reliable information on the subjects pertinent to his own condition and care. To fulfil that duty, the emotional load MUST come off, and that "habit of reasonableness" (see George H. Smith) which is the sine qua non of human function must come into operation. . . My own experience has been that patients and/or their caregivers CAN get this stuff. The presentation has to be couched properly, but if you can teach a medical student - possibly the dumbest creature this side of the U.S. House of Representatives - you can teach it to anyone."
I'd be interested in hearing your thoughts. And if you know of such on line information, that also would benefit myself and any readers who happen across this article.
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I'm sorry to hear about you husband. That must have been a truly horrible experience. And I'm sorry you your lesson was so dreadful too.
I hope your husband is better. I can't even imagine!
Dutchess - Way back when... I had some bigtime surgery, etc., and a shot in the rear with morphine really took care of some grade-A-#1 type pain. However, the docs wanted to do a procedure on me as I was recovering from all of that nonsense, so the corpsman gave me a syringeful of morphine in an arm vein. Doggone near did me in with an almost heart attack. Never again - not intravenously. I don't think that the shot killed me, however, but it caused me to remain stupid. :-)))
Most of us - at least in India - don't bother about what medicines we might be administered when admitted in hospital for surgery or an illness. The nurse gets the pills at the appointed time and one swallows them. Or someone asks one to turn over or roll up a sleeve for a jab in the bottom or arm, and one does that too. If one is in hospital, one might as well be there with full faith in its staff.
I do always hope and pray for good health, for myself and my friends, including a certain Duchess - may you never have to be admitted in hospital again or take any sort of medication. Remain happy and remain well! :)
Common Gus, you are not stupid. I don't like that word when it's been applied to my friends.
Jaspal, have you spent much time in the hospital in India? Sounds like you know the routine.
Thanks for adding me to your list of prayers for good health! I am honored.
Hi Duchess, thoughtful Hub. Luckily I've never had morphine administered, but it is a very powerful drug and as such needs to be used with caution. Thanks for highlighting some of morphine's pros and cons. Have you ever tried Hypnotherapy for pain relief?
No CMHypno I can honestly say I have never thought of hypnotherapy as a form of pain relief. In fact I have never had anything to do with Hypnosis at all. Have you tried it? Does it work?
Interesting as always, Duchess. Good info. I'm glad your pain (along with the kidney stone) has passed.
And as always Paradise, Thank you.
I'm very happy they have both passed as well. :)
I'm so happy that you are well again, Dutchess. Your research is well-received. I don't even like to take an aspirin, so I can't even imagine morphine! Thank you for the info.
Thanks Judydianne. I'm not big on medication either. Thanks for your well wishes and comments on the article.
I am happy to see you well again. Morphine is not really a pleasant drug. I was given this drug several years ago when I had major surgery but after two days I asked them to take it away and reduce my pain meds to something by mouth. I suffered severe headaches and it was not worth it. Good piece.
Very happy you are better! Very interesting and informative hub!
Lets not forget the terrible side effect of creeping paranoia. When I was in the hospitol they kept asking me why I didn't push my morphine button. Because morphine can cause some weird thinking, very unpleasant.
Thanks for your well wishes ladies. It's amazing how many people have been administered Morphine and how wide ranged the effects are. Thank you all
@Smireles, good to see you.
@Godslittlechild, thank you
@Dolores, interesting side effects you mentioned.
Here's to none of us having to use it again! :)
Hello again, Dutchess - I had a great good friend (who was also my boss at the time) who had kidney stones and the resultant pains upon attempted passages. His only treatment was a couple of gallons of distilled water daily until the stones rolled down the tubes. I really believe that I would have opted for the morphine. Anyway, I feel super-dumb today. Just landed a welcome writing contract for which landing our nice Hubpages helped a whole lot. If I can be stupid like that more often, I'd really appreciate the opportunity.
Stupid is one thing. Lucky is another.
Oh, I hear that Gus! They told me at the hospital they don't know what causes them either. I find that hard to believe. But I can tell you that fluids speed up the process. I was really lucky by the sounds of things. 4 hours and I was done, back home and getting the Thanksgiving dinner on the table.
Hi Duchess, great hub, reminds us that medications such as these are no game and very dangerous..
Yes edguider, they can certainly be very dangerous, fatal even. It's one more thing on my "list" I am preparing in case I ever have to make another trip to ER.
I remember having to push this drug at clinicals. I was so scared that my patient would stop breathing as I pushed it ever so slow. There is a chance with any drug that you could have possible severe side effects. That's why you must talk to your Dr. about history of allergic reaction to any meds.
Great hub. Thanks for sharing.
Yes, I agree Useful Knowledge, it's absolutely essential to keep a medical history and share it when medical attention is required.
Thanks for stopping by
I had no idea they still prescribe morphine. Thanks for making me aware.
This wasn't actually "prescribed". It was "administered" in ER. But I do believe in some chronic cases such as cancer treatments, or broken backs etc, this can still be a viable drug of choice - depending on your reactions.
I'm not a doctor, that's just from what I have read on the subject.
I had morphine for the first time a few months ago after surgery. After the second dose I too refused it. First it felt like I was having a heart attack and it never took the pain away. For about 10 minutes it made me not care about the pain, but it didn't take it away. And after 10 minutes it didn't work anymore. The second dose made me vomit and didn't even work anyway, so I said no more. Not worth it to me. Hope you are feeling better.
Hi Jennifer - I thought that maybe I was 1 in a million when I had that "heart attack" thing from IV morphine. They were going to do something to my body while I was in my hospital bed. First the heart pain, next the chest constriction, and finally the absolute fear that took over. There were about 10 resident docs there to assist the surgeon. They couldn't hold me down and they all finally gave up. Next day, they came at me again. I threw their glass syringe full of morphine onto the floor where it broke. The surgeon really screamed at me for that. I screamed back and told the guy to do whatever he was going to do, but no morphine. He did. It did not hurt, not even a little bit...and it worked really nicely. Morphine in the muscle is way different from morphine in a vein. Maybe we should all of us check out why such a difference. Gus
Hi Jennifer. Sorry to hear of your experience (you too Gus).
Not much has been said so far about how well it worked. Makes you wonder why they use it.
Gus, about checking out the difference between injections in the vein or muscle. Sounds like Hub material to me. Want to tackle that one?
Morphine sulfate is a drug with which physicians and pharmacologists have a tremendous amount of experience, and that experience has resulted in extremely high levels of knowledge. This kind of knowledge enables morphine and its analogs to be used with good safety and robust efficacy in the management of patients presenting with a number of clinical conditions.
People without a good understanding of the pharmacodynamics and pharmacokinetics of morphine and the other opiates - and without either training or experience in their use - tend to go off the rails when discussing compounds like morphine sulfate. Especially in the idiocy of our current "War on (Some) Drugs," where propaganda has made of the word "addiction" something that sends the gullible up the wall, the sort of failures found in this article and subsequent comments is understandable even though they're still horribly stupid.
You're on the World Wide Web RIGHT NOW, people. You can dig into the Merck Manual Online, find CME content written for doctors and nurses and pharmacists, and look into the subject using rigorous and reliable sources without dithering like a flock of mutton on the hoof.
Think about it. Pre-loaded morphine sulfate syringes are kept on the crash cart in the ICU and the Operating Suite and the Emergency Department. In acute cardiopulmonary resuscitation, intravenous morphine sulfate can literally save the patient's life by "unloading" a damaged and poorly-functioning heart, helping to preserve myocardium in the presence of murderous ischemia.
(Yeah, it lowers blood pressure. Ever heard of Starling's law of the heart? Reducing blood pressure in a cardiac code is an acceptable consequence of reducing venous return to the heart and thereby cutting down the heart's workload. That's why morphine sulfate is used. A temporary drop in blood pressure is something with which we can cope; a totally dead ventricular myocardium means you're going to need a transplant - and you're more likely going to just plain die.)
Doctors and nurses and pharmacologists are not in the business of harming patients. They calculate risks against potential benefit every time they question you, examine you, and treat you. Every time.
And the use of morphine and similar compounds is undertaken only after diligent consideration of the risks you - as a patient - are facing.
Tucci, thank you for a very comprehensive response. We are sorry you find our comments stupid, and are thankful for the information you have provided. The learning process for all of us has been improved with your information and places to go to look up the useful facts.
No one here thinks that doctors or nurses are in the business of harming patients. Quite the reverse is true.
Duchess, that response was hardly "comprehensive." If I knew how in the context of this forum, I would've provided links to information sources that make the complex subject of opioid agonist use comprehensible to people without formal training in pharmacology. There's a LOT of stuff online, much of it written for nursing students who have to tackle this subject at the undergraduate level (no precedent training in organic chemistry and biochemistry, for example), and come at things with a very practical and very effective "nuts-and-bolts" approach. You would certainly find it well within your grasp, I assure you.
The patient has himself a duty in the clinical relationship, and part of that duty involves the acquisition of reliable information on the subjects pertinent to his own condition and care. To fulfill that duty, the emotional load MUST come off, and that "habit of reasonableness" (see George H. Smith) which is the sine qua non of human function must come into operation.
There's a lot of fault to be found among physicians, though. As a profession, we simply don't do a good job of explaining things to patients or their family members - mostly because when we've tried to do so as young and impressionable "Dr. Kildare Wannabee" types, we came soon to the conclusion that we were speaking in the equivalent of Urdu.
My own experience has been that patients and/or their caregivers CAN get this stuff. The presentation has to be couched properly, but if you can teach a medical student - possibly the dumbest creature this side of the U.S. House of Representatives - you can teach it to anyone.
I was very enlightened by the comments made on the subject of morphine. I currently have to take morphine, due to back surgery a year ago that made my condition worse. I agree with both sides of the coin. The side effects are horrendous but it is the only thing that calms the intolerable pain I have. The pain is so severe that I have suffered the same effects from pain that I may suffer from the morphine. I try to keep a close eye on my reactions to this medication and never add an extra dose. This is a highly addictive drug but the pain can also cause me to have a heart attack. Some of us are in a catch 21, can not tolerate the pain. At this point I am just happy that there is some drug that helps.
patricia, don't be afraid of structured and carefully considered dosage escalations. Your bodily metabolism becomes "practiced" in the removal of foreign substances, and morphine is definitely a foreign substance that must be removed from the body.
This phenomenon is called "habituation," and you can find much about it online.
One of the better pain management tactics is to provide the patient with an oral formulation of morphine (or another opioid) that releases from the gut in a slow, predictable fashion. This provides a "baseline" cover for continuing pain such as you describe. This can be supplemented with variable doses of short-acting medications, given either orally or by injection to handle upsurges in pain.
This is very much standard operating procedure. Web search "ahrq-dot-gov" and use the Agency for Healthcare Research and Quality "search" function to enter "pain management." You'll find detailed guidelines on the subject as it pertains to a number of medical conditions.
Another AHRQ portal is the National Guideline Clearinghouse, which is where I more commonly go to pick up reliable current recommendations for disease management. Use the "search" function there with "pain management" as your keywords.
If you are not now under the intermittent but continuing care of somebody experienced in pain management (most of the ones I know are anesthesiologists), see if your primary care provider can hunt one up for a consultation. Even if you only see him once or twice a year, having a pain management guy current on your case offers nervous nellies in clinics and hospital Emergency Departments some reassurance that you're not a "drug-seeking patient" simply looking to get a buzz on.
What a great hub
Tucci, it appears to me that your contribution has been immensely helpful. I hope to see your participation with a few hubs yourself. In fact, I look forward to reading them. Thank you again for your participation.
Patricia, I certainly hope that Tucci's comments are helpful to you as the patient in looking up the correct information. I'm quite happy to see this and hope it helps you.
Mdawson. Thank you and welcome
Thank you Mdawson for the warm welcome. I appreciate the response to my comment. Tucci you seem very knowledgeable and give good advice. I am happy to be aboard. I an sure this will not be our only communication. Hello to everyone!
Many people still don't realize the addictive properties of Pharmaceutical pain relievers. Some doctors pass them out like candy, with no regard for the likelihood of addiction of the patient. Painkiller addiction seems to be less taboo as well. The fact remains that people go through misery trying to recover.
Hello Patricia! Thank you for your participation in the particular Hub.
Portamenteff, thank you for your comments as well. I truly think that Tucci's comments are beneficial and enlightening in regards to your comments. Pain relief is a pretty wonderful thing when you are going through it. And yes, it's partially up to the patient to be aware of the medications that are prescribed.
I truly hope this hub and the subsequent comments have been helpful in that respect.
Hi Duchess.
I have never liked the idea of morphine for any reason due to it being "as bad as heroin". Nowadays in Australia when in labour they give you morphine instead of pethidine. I have no idea why. I think it's ridiculous. Everyone who has had a morphine shot while in labour (that I know anyway) Has said it is entirely useless and the staff have always become suddenly worried about the baby about to be born. Thankyou for doing this Hub as I have a friend who is about to have a baby and this hub will help me ensure that she makes an informed decision about pain relief in labour.
Very interesting.
I've never had to take morphine in the hospital, but I know my late father had to once or twice after a surgery. I believe he hallucinated wildly on the stuff, so if I ever have to take it, I hope my reactions are not like his.
Welcome Phoenixarizona and gracenotes. I did not realize this would be such a hot topic when I wrote the hub. Many points of view on both ends of the spectrum.
I just want to say one thing. I am not a medical professional and I certainly do not have all the answers. This is a result of a personal experience and the little bit of research I did on the subject because of it.
I have to say, I have learned a great deal. Mostly to be thankful that those in the medical profession know their job and what they are doing
What an interesting hub! My father had morphine in the late stages of liver cancer and it provided him with a lot of relief. He did come up with some crazy comments though which actually served to make us all laugh at a time we desperately needed to. Thanks for the great hub - isn't it fascinating where we draw our writing inspiration from? :-)
Aqua, I'm sorry to hear about your father. but if it helped him, I'm glad.
Yes, it is fascinating where we draw our writing inspiration from :)
I didn't know we could talk about morphine on hubpages, good to know
good advice on this topic
i'm sure it'll help a lot of people
Interesting that you would say that Csjun89. I never thought it might be prohibited. Hmmm. now you have me thinking.
Yes Duchess, morphine is a hot topic these days seems to be.
I agree with Tucci, if this pain medication is taken under
the proper supervision (pain management) it is helpful to those with severe pain. This drug is not given to patients
who have mild to moderate pain. Sometimes one experiences severe side effects due to elevated prescribed doses Usually when one has a euphoric feeling from any meds the dose is to high or that particular medication does not agree with the person.. This is a drug that has to be monitored by your pain Dr. and yourself. It is like any pain meds they all have side effects, for that matter any drugs given by a doctor have side effects. This is not a drug that you can easily get prescribed. Morphine is usually given under circumstances for severe pain.There are withdrawal symptoms from any prescribed drugs. With a doctors guidance and monitoring the drug yourself it is not as bad as some of the drugs we are being offered.I am not a person who likes any chemical form of medication but when the body can not tolerate the pain you are almost willing to try anything to subside the pain. Before I took morphine I was given many pain drugs that also had terrible side effects and did not even subside the pain, all with severe warnings.At least now I can move around and function . Finally I have come to the safest level of relief. When dealing with pain meds one should always seek a pain specialist and consistently be monitored.I am happy that there was something out there that helps me. Any medications have side effects. It is also up to the patient to help the doctor by telling the truth about how the drug makes them feel. I am under close watch with my pain management.I trust taking this pain medication over getting the N1H1 flu vax.There is no management for that vax.
Patricia, thank you for your common sense approach. I'm hoping you are able to monitor your requirements, and that they continue to help you
I get bad migraines, and I occasionally have to go urgent care or the ER. One time when the other IV meds failed to help, the emergency room gave me morphine for the pain. It worked like a charm but I knew that I could never let them give it to me again. I felt sick, but it worked too easily, and I would never want to be addicted to anything.
I'm sorry to hear about the migraines. I know people who suffer from them and they can be debilitating. I can also agree that you need to be very careful. I expect that any time of pain medication can be addictive.
It's too bad they couldn't find a cure for migraines.
Thanks for stopping by.
thank you - that was very informative. I have recently been diagnosed with an underactive thyroid and didn't know that I shouldn't be prescribed morphine if, heaven forbid. I should ever need it.
Suki C:
Primary hypothyroidism ("underactive thyroid") is a condition that's a lot more common than most people realize. It can either be clinical* (with signs and symptoms which are - from a doctor's point of view - pretty clearly pathognomonic) or subclinical (which is by definition a kinda subtle laboratory diagnosis, though nonetheless capable of doing damage).
Subclinical hypothyroidism is much more common than the more easily diagnosed clinical condition. I've read estimates of incidence approaching 10% - or better - in certain populations in these United States, particularly in the later decades of life. There's a helluva lot of variation on the bases of ethnicity, region of the country, individual past medical history, and suchlike.
Well, hell. If it was too easy, they wouldn't pay us the big bucks, would they?
The fact that bradycardia is one of the signs (and pathological manifestations) of clinical hypothyroidism does NOT mean that the use of drugs like morphine sulfate is absolutely contraindicated.
Whether your condition is clinical or subclinical (the latter really defined by too-high serum levels of thyroid stimulating hormone, not by too-low levels of thyroid hormone in the bloodstream), correction of primary hypothyrodism by dosing with supplementary synthetic levothyroxine (under the brand names "Synthroid" and "Levothroid") pretty much makes the fix.
And then - with due caution, as always - a physician can make use of morphine sulfate in your treatment IF your condition warrants.
Hey, it's complicated. But it's not rocket science.
---
* From our friends at the British Medical Journal, we get the following list: "mental slowing, depression, dementia, weight gain, constipation, dry skin, hair loss, cold intolerance, hoarse voice, irregular menstruation, infertility, muscle stiffness and pain, bradycardia, hypercholesterolaemia, combined with a raised blood level of thyroid stimulating hormone (TSH) (serum TSH levels over 12 mU/L), and a low-serum thyroxine (T4) level (serum T4 under 60 nmol/L)."
One of the reasons why Alzheimer's disease is a "rule-out" diagnosis of exclusion is that there are a bunch of metabolic conditions - hypothyroidism prominent among them - that can produce identical signs and symptoms.
There's a technical legal term for the doctor who fails to run the proper "rule-out" evaluation before diagnosing an elderly patient as suffering from irretrievable "senile dementia."
That term is "defendant."
teendad:
Migraine sucks. It's a confusing condition to begin with, almost impossible to assess on the basis of objective diagnostic criteria (lab tests, imaging, etc.), and the people trying to treat patients with migraine cephalgia have tremendous difficulty groping their way to effective tactics of prevention and mitigation.
You're not the only guy with the headache.
There are a ton of treatment guidelines pertinent to migraine cephalgia. I'm inclined to go with those of the American Academy of Neurology (AAN) even though their most recent summary document on the management of adult patients was uttered in 2000. For that, go to:
http://www.aan.com/professionals/practice/pdfs/gl0
The companion summary for migraine management in children and adolescents was revised most recently in 2006. See:
http://www.aan.com/professionals/practice/guidelin
There are patient information sheets (which I personally consider entirely too damned "dumbed-down") made available by outfits like the National Headache Foundation as well as the AAN.
The problem with all the material available online is that you can get "firehosed" pretty readily.
If your migraine attacks are frequent and severe - and there are criteria by which such frequency and severity can be roughly assessed to determine whether or not pharmacotherapeutic intervention is justified on a risk/cost/benefit basis - your doctor can consider chronic NON-narcotic treatment with medications of all kinds, including a bunch of treatment options which are NOT supported by evidence-based medicine (EBM) standards but which have worked in some cases.
Remember that EBM involves a rigorous methodology, and pushing through that methodology is costly. Drug formulations that have gone off-patent - cheap generics - don't justify the studies required to get EBM-level proof of efficacy, so ancient options like Bellergal-S (a combination of ergotamine, belladonna alkaloids, and such a tiny amount of phenobarbital that the product isn't on the CDS schedule) won't show up as anything but the equivalent of voodoo in the treatment guidelines.
Most younger doctors weren't in practice when Sandoz was an independent company (it got swallowed up in those mega-mergers which got started back in the '90s) and Sandoz sales reps used to visit doctors' offices.
The damned pill LOOKS silly (like compressed confetti), and I thought the dosing levels bordered on the homeopathic, but when there were patients whose migraines simply would not respond to other preventive options - or they had other medical conditions which made the other options problematic - I figured, what the hell....
And more than a few had less frequent, less severe migraine attacks while they were taking that stupid pill twice a day. The ones who didn't respond seemed not to demonstrate any ill effects attributable to therapy, and so I remark to this day that "old and broke-down" doesn't necessarily mean ineffective.
Younger physicians don't get this, chiefly because you have to get old in this racket before you get a hold on just how NOT a science the evaluation and treatment of living human beings really is.
Suki, It's good that you know at least.
You may not have actually been administered pure Morphine. There are many derivatives and doses. In the narcotic pain relivers you list above many are brands but not the actual drugs. Lortab, Vicodine are brands for Acetaminophen / hydrocodone mixes.
It's hard to know what part of a drug mix may cause what kind of pereceived or actual adverse reaction. The Doctors usually don't tell you the exact drug because its not important. As long as you do not have an immediate allergic reaction your alternative is to endure the pain.
All drugs have side effects, if you had a true adverse reacton you should tell your Doctor so they know not to give you that same drug the next time you might need it.
I have some very specific reactions to some medicatons so I've done a lot of personal resseach on what is really in OTC and prescription pain relievers.
We are going to have to agree to disagree Mike. I think it is very important that we know the exact drug that has been administered, especially if there are side effects.
I will agree that an adverse reaction requires you tell your doctor, and by the same token, the patient has every right to know what drug has been administered.
Mike, I have to second the Duchess' position. Whether or not a patient can be said to have a "need to know," I can't think of any reason why a physician wouldn't WANT him to know - in some detail, and accurately - about each and every medicine he might take, and that includes the various opioid agonists.
That's true if for no other reason that the patient might wind up emergently under the management of another health care provider, and not being able to tell that doctor or nurse or PA what's been used in his treatment could conceivably result in problems, up to and including a trip to the hospital basement with a toe-tag.
Even were there no "right to know" (and there surely is), there's an eminently practical reason why full disclosure of this information to the patient is standard of care.
About 20 years ago I really badly smashed up in a car crash. I brok my pelvis in three places and spent 6 weeks in hospital, 3 of which were in traction.
They gave me morphine for the first three days, I was in a lot of pain. All I can say is that I have no idea why anyone would want to take this as a "recreational" drug. It did help with the pain but half the time I had no idea where I was. I was also very jittery and nervous.
Anyway - I think you were very wise to refuse further doses.
Thamisgith, wow, 6 weeks in the hospital! Sounds like you had a rough time of it. It's amazing what the human body can withstand. I hope you had no lasting ill effects.
Interesting hub! I'm not much into medical topics, but this I found interesting. Hospitals scare me to death and it's always nice to have these facts if you happen upon a situation where you want relief for your pain while being aware of the side effects of the pain reliever. Currently, I find it hard to trust medicine until I'm sure I'm informed on the side effects, because sometimes you'll find the risks and side effects are more terrifying than the pain! Thank you for this intellectual article.
nice post. very informative.
Thanks everyone!
Unwritten, I'm not usually into them either, and this is not really a medical hub so much as a personal experience hub.
Thanks for popping in
kidney stones... YIKES!
I feel for you.
I learned about them in school, and then from a couple of friends who get them frequently.
Cant imagine how bad that must have felt.
Glad you are done with them, and glad you didnt get hooked on opiates!
I was administered Morphine a few years ago intraveneously after an accident at work. The doctor had already administered 2 other types of pain medications and my body had not responded. For some unknown reason my body is extremely slow for any medications to take an effect, especially pain meds.
After the Morphine and about 10-15 minutes, I became very "out-of-it." The pain did subside, as I think my brain my have also. lol I was very "loopy" for a few days.
I did not know about the asthma warning with this drug. I do have asthma. Maybe that is part of the reason my effects lasted for days, as well as the ton of drugs used on me.
Note: I was in so much pain when I was at the E.R. there is no telling what I told the triage team. It was a few weeks before I even remembered all details of the accident!
J-Art, thank you for the well wishes.
Michael, it's pretty scary when you can't remember what you told triage! I'm glad that in the end, you are ok - even if you were a little loopy for a day or two.
J-ART, renal colic (the pain caused by passing kidney stones down the ureter into the bladder) is supposed - literally - to be the single most agonizing visceral pain short of that associated with cancer. Somewhere I recall that dolorometric analyses ranked it just above the pain of acute gouty arthritis.
What's improved in dealing with the condition over the past couple of decades is uretroscopic intervention. The surgeon urologist can now not only get a cystoscope into the bladder but an even smaller fiberoptic instrument up into the affected ureter. Using such a gadget, the surgeon can then either "basket" the stone and ease it out or use high-frequency sound energy to shatter the nasty little bugger, reducing it to easily-passed gravel.
A close friend of mine is a urologist, and I dasn't get him talking about his latest up-the-kazoo adventures for fear that it'll take hours for him to run down.
But if I ever pitch a rock, I most assuredly want him in on the case.
Dutchess - What a winner of a hub ! If I may, I want to tell Tucci, too, to keep on keeping on. Another winner, that one! Gus
Yes Tucci,
You do have very sound advice. Are you a Dr.? A quick question in some cases as described above in a hub, when a patient can not remember anything from morphine, were they over medicated? I take a total of 275 mg of morphine 3x a day for chronic pain. I have never had a moment where I forgot things.The meds go straight to the pain, I never feel "high" or any side effect except the constipation deal. I was on Kadian 300-500 mg as needed per day and did not have an issue with that either. My back pain is severe it doesn't let up, but the morphine makes it tolerable. The only problem I did have on Kadian was I lost about 25lbs , which for me is alot I am a very small lady. Are there any other pain meds that are better than morphine and time released. I have tried many. Opana er and many others. I must have a high tolerance to pain meds.Thanks for your hubs I find your info factual.
patricia
Thank you Gus!
patricia, you've sent me scrambling for open-source online information (stuff which you don't require either a journal subscription or a professional society membership to access), hoping to share it with you, but what's out there at the levels of thoroughness and reliability I consider appropriate to cite might not be what you personally can use or need.
I'm going to try to interpret this stuff, and when I get it wrong - and I'm virtually guaranteed to get some of it wrong; I'm a GP, not the sort of skilled and experienced chronic pain management guy whose consultative services and recommendations I would want to get in a case like yours - let's both keep in mind the thought that there's going to be better understanding to be gotten elsewhere.
Lets look at the upward titration of your morphine dosing.
The development of tolerance is well understood. Pulling flagrantly from a California Society of Anesthesiologists CME activity by Dr. Palmer:
"...studies of chronic administration of systemic or intrathecal opioids suggest that while prolonged pain relief can be obtained in many patients, there are patients with nonmalignant pain who tend to require escalating doses of opioids over time. The study by Paice demonstrated over a 600% increase in intrathecal morphine dosing in non-malignant pain patients over a two-year period. Mystakidou reports some patients escalating from 75 mcg/hr or less of transdermal fentanyl patches up to 250 mcg/hr within 18 months."
To explain a bit, one of the tricks that the anesthesiology people have come up with to abate chronic pain is the infusion of morphine directly into the spinal canal ("intrathecal"), and for decades we've used fentanyl - a synthetic molecule about an order of magnitude more potent on a milligram-for-milligram basis than morphine - in through-the-skin delivery systems like Duragesic patches.
Pharmacological tolerance - habituation - is not only known but expected. If you DIDN'T develop a physiological "aptitude" for taking morphine out of your system and getting rid of it - and therefore requiring increasing doses of morphine to get pain relief - there'd be something wrong with you. Might as well be surprised when somebody who lugs around a thirty-pound suitcase twelve hours a day develops a set of muscles.
Now, because the objective of administering any opioid (morphine sulfate, fentanyl, hydrocodone, methadone, whatever) is the control of pain, it's hard to speak of someone being "over medicated" providing they're getting adequate pain control and the side effects profile is such that the patient and the prescriber (working together) can cope to their mutual satisfaction.
The constipation problem you'd mentioned receives a helluva lot of attention at CME seminars on chronic pain management. The average person would be surprised to learn that such a supposedly trivial issue gets as much worry-time when doctors and nurses and patients get together to work out ways to deal with chronic pain, but when you've had to deal with it yourself or care for a patient who suffers opiod-induced large bowel "lock-and-load," it ain't funny and it ain't negligible.
After you've had just one patient wind up on an operating table for an anterior resection for no other reason, however, you will not approach chronic constipation as anything other than a potentially grave threat upon which you had by God better focus.
You're correct in your surmise that the dosing of opioid agonists in the management of chronic non-malignant pain should not interfere with higher mental functions, particularly memory. That's generally a sign of dosing that ranges too high, and which requires adjustment to get the desired effect without pounding down the patient's ability to think, to remember, and - critically important - to work as an active participant in his own care.
The patient - you, me, everybody - is not just a lump of clay to be molded. We each have an important role to play in our own medical management, and to the best of our ability, we have each a responsibility to stay as clear-headed and alert as we possibly can. Good prescribers understand this, and jigger the meds to make sure that lucidity and attention are not impaired.
Good hub, my friend. I, actually, really enjoyed it when I had it... this is a concern in itself, I think! Wishing you well x
hmmm shazwellyn. You are right, this could be a concern!
Thank you for your well wishes.
Wow, this is enlightening to me. The only thing I knew about Morphine was that it took away pain. Punto. I'm glad I read your Hub which gives a fuller picture. I hope you never have the need for Morphine again.
I had it administered once and didn't think about any side-effects, I just wanted the pain to go immediately.
Wishing you good luck with the Challenge. Your Hubs are very interesting. :)
Hi Lady_E, I'm glad it was enlightening. I only wrote it because I had the one question. It has certainly generated a LOT of comments.
Thanks for your well wishes.
I've enjoyed reading this hub very much and all the comments. My experience with morphine was 5 years ago when I broke my back and neck. I'd lost 3 vertebrae and when they were trying to determine the extent of the damage I was screaming in pain when they moved me. They gave me morphine and when I 'came to' after the op it was to find a morphine drip in place, wih a push button to administer my own dose when I needed it. Can't say I had any side-effects. I was just relieved to be out of pain. As I couldn't move anyway I think I slept for the three days or so I was on it.
Anyway, I am rebuilt with metals and pins (bionic woman) and I am fine now more or less:)
I was a nurse many years ago, and saw many a patient in Casualty in tears with the pain of kidney stones, so I'm not surprised they gave it to you. It was always the strongest painkiller to hand and in certain situations is invaluable. Glad you're OK now:)
Wow, I know my own personal bionic woman - how cool is that! Sounds like a serious time you went through! I'm very glad you had this particular pain killer at the time!
And thank you for the visit.
Morphine was my nemesis. 1973 I wrecked a speed boat racing in Florida. 22 broken bones among other injuries. I was hospitalized 2 1/2 months and then another 3 weeks to break the morphine habit. I felt terrible for about 2 years before I got back to being myself. Not fun.
oh my, it certainly doesn't sound like fun. Sounds like a very tough few years. I'm glad you made it through that.
I know this hub was several months ago but I need some advise-My brother Guy went to the hospital with Kidney Stones and was given morphine (I do not know dosage)for the pain. He was admitted because he couldn't pass the stone and they were going to "blast it" the next morning. He was checked on at 2:30 in the morning and was having some breathing difficulites and given oxygen. His saturation was approx 79. He was dead 45 minutes later. At first the hospital said he would have an autopsy, which we were fine with, then they found his name on the national register for donations and though he couldn't donate his major organs he could donate tissue and his eyes. We did the donation. However I'm so overwhelmed to wonder how and why this could have happened. I talked to his primary doctor this morning and he said when Guy flatlined he was given Naloxone to counter act the morphine and was worked on including paddles for 15 or so minutes. He said Guy's heart did come back for a few seconds then flatlined again. He suggested that a blood clot might have traveled to the heart but he admitted we just don't know. Is there anyone who can help?
Gail, I am so very sorry to hear this tragic story of what happened to your brother! I am even more sorry that I don't know how to help you. Perhaps some of the others here might be able to. I hope you do find the answers you are looking for.
Without going into the details, I landed in a hospital with many broken bones and morphine was administered for two days. For those two days I was pain-free. Not euphoric, just not hurting anymore. Then it was cut off, to prevent constipation. Codeine was substituted instead, which relieved the pain somewhat, but never totally. Two weeks later, before surgery to remove a steel rod from my elbow and forearm, I was given Demerol (by IV). Heaven! Conscious but feeling NO pain - similar to being stoned on really good pot. I deduced I could never become addicted to morphine, but was extremely glad I didn't (and still don't) have access to Demerol.
JamaGenee, this sounds like a horrible time for you! I hope you are better (if it was recent) and feeling no reprocussions. It sounds awful!
Demerol. Good to know there is something out there that helps when it is needed. I'm happy you didn't become addicted, it sounds like it would be an easy thing to do.
A very informative hub. I have experienced morphine and its side effects following surgery on several occasions. Thankfully I did not have a reaction nor was I in the hospital but only for a short time. I can see where this would be a potential problem. And I agree 110% with you that we should always be informed as to the drugs we are given, and should always have the right of refusal.
Glad things tunred out OK for you and you are here to share your ordeal with others.
Hi DustinsMom! Thank you for dropping in. I'm very thankful you did not have a reaction as well. And thank you for your well wishes. At the moment, I know someone dying of cancer and I have to add that for her I am very thankful for the morphine. It is making her last days so much more comfortable.
Thanks for sharing your experience with morphine with us. This is an informative and great hub.
oceansnsunsets. I'm sorry to have overlooked your comment! Thank you for stopping by
Duchess - lets not forget one of the common symptoms of morphine use - paranoia. Which I experienced myself after a surgery. My poor mother suffered terrible paranoia after being given morphine after surgery. Seems like if you go to the ER, they had out morphine for anything. No thank you, doctor.
I did forget that particular effect until a more recent experience with another family member. You are correct, that can be a horrific experience. thanks for the additional information in your comment and thank you for your visit
Yes, Morphine can be dangerous in some situations. If you have a right sided MI(Heart attack) and you give morphine, you can lower the patients blood pressure so much that it could be fatal. If a patient is having the big one, which is the LAD coronary artery, Morphine is great. It helps relax the patient, the heart will relax which uses less oxygen, it also dilates arteries allowing more oxygen to the heart. Morphine is also great for pain. I like using Fentanyl better though.
patdmania - do you use Fentanyl at work? You are a fire fighter correct? I didn't know firefighters administered that kind of assistance. Interesting
This is a very interesting hub as I have low blood pressure. Thanks so much for writing this!
A pleasure Susan
I bookmarked this one - Codeiene caused dangerous low BP, etc. when I was 6. Allergic to morphine (shudder).
I'm shuddering with you Patty!
Just went through spinal reconstruction and fusion from tailbone to bra strap area 2 months ago. Twice before I had problems with Morphine, and forewarned anesthesiologist, PAs, etc. that it was not effective for pain, and that I kept "passing out" after being administered Morphine. I didn't consider it an "allergy" so didn't use that buzz word. I did ask them all to monitor me and if they observed those problems, to take me off Morphine. Well, they didn't pay attention to my very clear requests.
First problem was it took them 1 1/2 hours to run IVs - whereas my veins are huge and plump, and nobody ever has problems with my veins. Next problem - (who knows if this is related to morphine) - I bled excessively. Ultimately required 20 litres transfused blood.
Next problem: I had to remain intubated in ICU for 6 of 7 days I was in ICU! Because of breathing tube, I had to remain highly sedated. It was a nightmare. Every time they gave me morphine I passed out. Blood pressure was very low, my breathing was extremely low.
At some points of lucidity I said no morphine. They ignored me. After 8 days in hospital I became lucid enough to realize they were still giving me Morphine. I INSISTED that I would not be given any further Morphine. From that point forward many side effects remitted.
I have surgery #2 ("Part B") coming up on Feb 15th. I can guarantee I have NO MORPHINE all over my chart now. Even Johns Hopkins can make errors. They did not attend to what I made a huge point of telling them verbally, but they do respond to the word "ALLERGIES".
OGM Susan - Have "No Morphine" painted on your forehead or something!
I wish you well and hope your surgery goes perfectly!
It's good to know I should say "allergic" next time.
thank you for writing this! I have low blood pressure and I'm in a crapload of pain every day. my boyfriend has been trying to convince me to ask the doctor for morphine but this information has definitely made my mind up!
supergirl, if your Doctor is aware of your low blood pressure, I'm sure he/she would advise you of the possible side effects. I hope you find something with your doctor's help - for the pain
I'm only 18 and weigh 450+ pounds. My doctor prescribed me 30 milligram Morphine sulfate. Extended release. It was for my severe back pain every morning. I took it and it helped the whole day. It was amazing. But the very first time I took it, I got a severe headache and really bad stomach cramps as I was coming down off it. I've since got my doctor to instead prescribe me 10 milligram Lortab. Morphine is most definitely NOT a friend of mine.
DavidJ1993 - I hope the Lortab worked better for you than the Morphine did.
Catherine R 2 years ago
Interesting hub. I hope you are recovered now. My husband broke his back last year and took oxycontin for a long time. He found it hard to come off them. One evening when I had a bad headache I took one of his oxycontins - I know I shouldn't have done but it made me violently ill. It was dreadful and it taught me a lesson I suppose.