morfiini

Morfiini, the Finnish term for morphine, is a potent opioid analgesic derived from the opium poppy (Papaver somniferum). It is used medically to relieve severe pain and as an anesthetic adjunct, but it is tightly regulated due to its high potential for misuse, dependence, and adverse effects.

Pharmacology and chemistry: Morfiini acts as a full agonist at mu-opioid receptors, producing analgesia, euphoria, sedation, and respiratory depression. It occurs in several salt forms and is metabolized in the liver to morphine-3-glucuronide and morphine-6-glucuronide, with the latter contributing to analgesia. Oral bioavailability is limited by first-pass metabolism, and elimination is primarily renal. The typical half-life is a few hours, but it can be prolonged in renal impairment or with certain formulations.

Medical use and administration: It is indicated for severe acute pain, cancer-related pain, and perioperative analgesia. Available formulations include oral tablets and solutions, injectable forms (IV or IM), and regional administration (epidural or intrathecal). Extended-release oral preparations and transdermal patches are used for persistent pain.

Adverse effects and risks: Common side effects include constipation, nausea, vomiting, pruritus, drowsiness, and sweating. Serious risks include respiratory depression, hypotension, and increased intracranial pressure in susceptible individuals. Tolerance, physical dependence, and withdrawal can occur with prolonged use. Interactions with other CNS depressants, alcohol, and certain medications can increase risks. Use in pregnancy and breastfeeding requires careful consideration.

History and regulation: Morphine was first isolated in the early 19th century by Serturner and named after Morpheus. It remains a cornerstone analgesic but is a controlled substance in most countries (eg, Schedule II in the United States, Class A in the United Kingdom).