Morphine Essay Example | Topics and Well Written Essays - 3000 words

Morphine - Essay Example hat these other common drugs either match in action the effects of morphine when acted upon by the enzymes, or they increase the effectiveness of the enzymes resulting in a faster, or more concentrated catalytic effect (â€Å"Drugs.com†, 2011). In the case of lasix, which includes a psychotherapeutic and CNS-active agent the patient might experience hypotensive effects when the treatment is first administered or if either of the drugs dosage is increased. There is also a coadministration factor with vasodilators and alpha-blockers that can increase blood pressure and othostasis. This interaction is not consistent enough across all patients to come to a conclusion as to why this happens, but careful monitoring of any patient on this type of treatment method is advised (Hammack and Loprinzi, 1994). iii. Note the clinical consequences of each of the interactions (e.g. increases the plasma concentration of Drug B leading to an enhanced pharmacological effect and toxicity). In all of the drugs in the previous section (except lasix) the concern is that the drugs, when combined with morphine have an additive or synergetic effect on the toxicity and potency of both drugs thereby increasing effectiveness as well as possible side effects depending on how well individual patients metabolize the morphine. Factors that would need to be considered would include type of illness, health of the liver, enzyme production and any built up tolerance to either medication (American Pain Society, 1999). Lasix can interact with elements such as alpha blockers or vasodilators which would put more stress on the heart due to increased blood flow and/or respiratory system (American Pain Society, 1999). Section 3. Drug absorption For morphine: a. Determine and state the oral bioavailability... The study has shown that morphine is metabolized to M6G which is a potent analgesic thereby increasing the effectiveness of the drug in some situations. As a rule, the metabolism of morphine comes through uridine diphosphate glucuronosyl transferase (UGT) enzymes which are found in the liver. The enzymes form active analgesic metabolites and in some cases toxic metabolites as well. This would indicate that environmental factors that could inhibit or increase the effectiveness of morphine would include conjoint use of other drugs that reduce or inhibit the effect of liver enzymes; liver disease or a liver dysfunction and any drugs that can increase enzyme levels in the liver itself. According to the AHFS drug information the bioavailability is influenced by gastrointestinal absorption but the amount of bioavailability depends on the method that is used to administer it. In reality the bioavailability is almost 90% first pass hepatic extraction. This is supported by literature that sug gests that the clearance rate for morphine is longer in those individuals who have hepatic impairment. In most cases the morphine is metabolized in the liver and dispersed through urination. The rate of conventional oral preparations (immediate release) and the extended release oral versions are about the same but there is a difference in peak plasma concentrations which are longer and lower with the extended release oral preparation.