MEDICAL TEXT

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Morphine Effects In The Human Body

Morphine

Systematic (IUPAC) name
(5α,6α)-7,8-didehydro- 4,5-epoxy-17-methylmorphinan-3,6-diol
Clinical data
Trade names	Mscontin, Oramorph, Sevredol(Morphine as a sulfate)
AHFS/Drugs.com	monograph
Pregnancy cat.	C (AU) C (US)
Legal status	Controlled (S8) (AU)Schedule I (CA) Schedule II (US) Narcotic Schedules I and III (UN)Prescription Medicine Only
Dependence liability	Very High (morphine, among other opiates are known to cause serious abuse, tolerance, dependence and withdrawal problems)
Routes	Inhalation (smoking),insufflation (snorting),oral, rectal,subcutaneous (S.C),intramuscular (I.M),intravenous (I.V), andintrathecal (I.T)
Pharmacokinetic data
Bioavailability	20–40% (oral), 36–71% (rectally),[1] 100% (IV/IM)
Protein binding	30–40%
Metabolism	Hepatic 90%
Half-life	2–3 hours
Excretion	Renal 90%, biliary 10%
Identifiers
CAS number	57-27-2  64-31-3 (neutral sulfate), 52-26-6 (hydrochloride)
ATC code	N02AA01
PubChem	CID 5288826
IUPHAR ligand	1627
DrugBank	DB00295
ChemSpider	4450907
UNII	76I7G6D29C
KEGG	D08233
ChEBI	CHEBI:17303
ChEMBL	CHEMBL70
Chemical data
Formula	C17H19NO3
Mol. mass	285.34
SMILES[show]
InChI[show]
Physical data
Solubility in water	HCl & sulf.: 60 mg/mL (20 °C)
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Morphine (INN) (/ˈmɔrfiːn/; MS Contin, MSIR, Avinza, Kadian, Oramorph, Roxanol, Kapanol) is a potent opiate analgesic drug that is used to relieve severe pain. It was first isolated in 1804 by Friedrich Sertürner, first distributed by him in 1817, and first commercially sold by Merck in 1827, which at the time was a single small chemists' shop. It was more widely used after the invention of the hypodermic needle in 1857. It took its name from the Greek god of dreams Morpheus (Greek: Μορφεύς).^[2]

After it was isolated from opium by Sertürner, the traditional way to obtain morphine had been by chemical processing of opium. In India, opium harvested by licensed poppy farmers is dehydrated to uniform levels of hydration at government processing centers, and then sold to pharmaceutical companies, which extract morphine from the opium. However in Turkey and Tasmania morphine is obtained by harvesting and processing the fully mature dry seed pods, with attached stalks, called poppy straw. By not harvesting opium at all, and by obtaining morphine only from the dry poppy straw, and not from opium, and by using a large scale industrial process to do so, at factories located near the poppy farms, opportunities for illicitly diverting opium from the crop, and for illicit production of morphine, and heroin from the opium, are reduced. In Turkey, a water extraction process is used. In Tasmania, a solvent extraction process is used.

Morphine is the most abundant opiate found in opium, the dried latex extracted by shallowly slicing the unripe seedpods of the Papaver somniferumpoppy. Morphine was the first active principle purified from a plant source and is one of at least 50 alkaloids of several different types present in opium,poppy straw concentrate, and other poppy derivatives. Morphine is generally 8 to 14 percent of the dry weight of opium,^[3] although specially bredcultivars reach 26 percent or produce little morphine at all (under 1 percent, perhaps down to 0.04 percent). The latter varieties, including the 'Przemko' and 'Norman' cultivars of the opium poppy, are used to produce two other alkaloids, thebaine and oripavine, which are used in the manufacture of semi-synthetic and synthetic opioids like oxycodone and etorphine and some other types of drugs. P. bracteatum does not contain morphine orcodeine, or other narcotic phenanthrene-type, alkaloids. This species is rather a source of thebaine.^[4] Occurrence of morphine in other Papaveralesand Papaveraceae, as well as in some species of hops and mulberry trees has not been confirmed. Morphine is produced most predominantly early in the life cycle of the plant. Past the optimum point for extraction, various processes in the plant produce codeine, thebaine, and in some cases negligible amounts of hydromorphone, dihydromorphine, dihydrocodeine, tetrahydro-thebaine, and hydrocodone (these compounds are rather synthesized from thebaine and oripavine). The human body produces endorphins,^[5] which are endogenous opioid peptides that function asneurotransmitters and have similar effects.^[6]

In clinical medicine, morphine is regarded as the gold standard, or benchmark, of opioid analgesics used to relieve severe or agonizing pain andsuffering. Like other opioids, such as oxycodone, hydromorphone, and diacetylmorphine (heroin), morphine acts directly on the central nervous system (CNS) to relieve pain.

Morphine has a high potential for addiction; tolerance and psychological dependence develop rapidly, although physiological dependence may take several months to develop. Tolerance to respiratory depression and euphoria develops more rapidly than tolerance to analgesia, and many chronic pain patients are being maintained on a stable dose, for many years.

Medical uses[edit]

Morphine is primarily used to treat both acute and chronic severe pain. It is also used for pain due to myocardial infarction and for labor pains.^[7] There are however concerns that morphine may increase mortality in the setting of non ST elevation myocardial infarction.^[8] Morphine has also traditionally been used in the treatment of the acute pulmonary edema.^[7] A 2006 review however found little evidence to support this practice.^[9]

Immediate release morphine is beneficial in reducing the symptom of acute shortness of breath due to both cancer and non-cancer causes.^[10][11] In the setting of breathlessness at rest or on minimal exertion from conditions such as advanced cancer or end-stage cardio-respiratory diseases, regular, low-dose sustained release morphine significantly reduces breathlessness safely, with its benefits maintained over time.^[12][13]

Its duration of analgesia is about 3–4 hours when administered via the intravenous, subcutaneous, or intramuscular route and 3–6 hours when given by mouth.^[14] Morphine is also used in slow release formulations for opiate substitution therapy (OST) in Austria, Bulgaria, and Slovenia, for addicts who cannot tolerate the side effects of using either methadone or buprenorphine, or for addicts who are "not held" by buprenorphine or methadone. It is used for OST in many parts of Europe although on a limited basis.^[15]

Rap

Rapping

Refers to "spoken or chanted rhyming lyrics". The art form can be broken down into different components, as in the book How to Rap where it is separated into “content”, “flow” (rhythm and rhyme), and “delivery”. Rapping is distinct from spoken word poetry in that it is performed in time to a beat.


Rapping is often associated with and a primary ingredient of hip hop music and reggae, but the phenomenon predates hip hop culture by centuries. It can also be found in alternative rock such as that of Cake and the Red Hot Chili Peppers. Rapping is also used in Kwaito music, a genre that originated in Johannesburg, South Africa and is composed of hip hop elements. Rapping can be delivered over a beat or without accompaniment. Stylistically, rap occupies a gray area between speech, prose, poetry, and singing. The word (meaning originally "to hit") as used to describe quick speech or repartee predates the musical form. The word had been used in British English since the 16th century, and specifically meaning "to say" since the 18th. It was part of the African American dialect of English in the 1960s meaning "to converse", and very soon after that in its present usage as a term denoting the musical style. Today, the terms "rap" and "rapping" are so closely associated with hip hop music that many use the terms interchangeably.

Etymology

Over many centuries, the meaning of the English verb rap was gradually extended from 'hit, strike, especially repetitively and rapidly' to 'parley', and finally, 'speak lyrics to a beat measure (whether or not the beat itself is physically present)'.

By the late 1960s, when Hubert G. Brown changed his name to H. Rap Brown, rap was a slang term referring to an oration or speech, such as was common among the 'hip' crowd in the protest movements, but it did not come to be associated with a musical style for another decade.

Rap thus etymologically means "fast read" or "spoken fast". It may be from a shortening of repartee.