Morphine exerts its primary effects on the central nervous system and organs containing smooth muscles. Pharmacologic effects include
analgesia, drowsiness, and alteration in mood. Reduction in body temperature (at low doses), dose-related depression of respiration, and interference with adrenocortical response to stress at high doses are also effects of this drug. Sometimes reduction in peripheral resistance with little or no effect on cardiac index and miosis are reported with usage of morphine sulphate. Nausea and vomiting may be prominent and are thought to be the result of central stimulation of the
chemoreceptor trigger zone. Histamine release is common; allergic manifestations of urticaria and, rarely, anaphylaxis may occur. Bronchoconstriction may occur either as an idiosyncratic reaction or from large dosages. Preservative-free Astramorph/PF (morphine sulfate Injection, USP) should be administered with extreme caution in aged or debilitated patients, in the presence of increased intracranial/intraocular pressure and in patients with head injury.
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