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morphine (Intramorph / Duramorph / Epimorph)

✓ Approved

Pfizer, Inc. · OPRD1 · 小分子

什么是 morphine？

morphine 是一种小分子，由Pfizer, Inc.研发。该药已获批，用于治疗相关适应症，给药途径：Injectable (Others)、Intraspinal/Intrathecal Injection。

药物档案

商品名Intramorph, Duramorph, Epimorph
公司Pfizer, Inc.
药物类别小分子
分子靶点OPRD1, OPRK1, OPRM1
给药途径Injectable (Others), Intraspinal/Intrathecal Injection
状态Approved
来源： ClinicalTrials.gov, Pfizer, Inc.

作用机制

分子靶点

morphine 作用于 3 个分子靶点：

OPRD1opioid receptor delta 1 (DOR, OPRD)
OPRK1opioid receptor kappa 1 (KOR1, OPRK)
OPRM1opioid receptor mu 1 (MOR1, LMOR)
需要更深入的分析？Noah AI 可解释复杂机制并与同类药物比较。

治疗适应症

morphine 针对 1 个适应症，涉及 1 个治疗领域。

治疗领域疾病/病症分期
Gastrointestinal disordersAbdominal pain✓ Approved

相关研究文献

PubMedThe British journal of radiology2026-10-26

Intravenous oxycodone versus morphine patient-controlled analgesia (PCA) after uterine artery embolisation: A propensity matched case-control study.

Clements Warren W, Markakis Demi D, Koukounaras Jim J, Venn Georgina G et al.

The use of intravenous oxycodone is still limited in the Interventional Radiology setting. This study aimed to assess the safety and efficacy of intravenous oxycodone used in patient-controlled analgesia (PCA) after uterine fibroid embolisation (UFE), compared to morphine. Retrospective case-control study. The study group consisted of patients treated with UFE between March and December 2024, using an oxycodone protocol. The control group consisted of a previously published dataset using morphine protocol. Primary outcomes were safety and the incidence of severe nausea. There were 57 patients in the oxycodone group compared to 69 in the morphine group. After propensity score matching, this left 43 in the oxycodone group and 60 in the morphine group. Groups were similar in terms of background demographics, however the use of smaller 355-500 micrometre polyvinyl alcohol particles were higher in the oxycodone group (100% vs 18%, p < 0.001).No analgesic-related adverse events were observed in either group. The incidence of severe nausea was lower in the oxycodone group (43.3% vs 37.2%, p = 0.533) despite a higher rate of post-embolisation syndrome (65.1% vs 48.3%, p = 0.091). After multiparametric logistic regression, oxycodone was associated with a 64% reduced odds of severe nausea (OR 0.36, p = 0.217). Intravenous oxycodone PCA is safe and showed a trend towards a lower incidence of severe nausea compared with morphine PCA. There is limited evidence of the use of oxycodone PCA to treat post-embolisation syndrome. This study showed it was safe and resulted in reduced nausea compared to morphine.

PMID 42928627
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PubMedActas espanolas de psiquiatria2026-10-26

Prevalence and Associated Factors of Opioid Withdrawal Syndrome in Adults Admitted to an Intensive Care Unit: A Retrospective Observational Descriptive Study.

Zalba-Etayo Begoña B, Serrano-Ferrer Clara C, Cabrerizo-García José Luis JL

Prolonged opioid administration for pain control and to facilitate tolerance of mechanical ventilation in the intensive care unit (ICU) may lead to tolerance and physical dependence. Following opioid discontinuation, opioid withdrawal syndrome (OWS) may occur. Although this condition has been well described in pediatric populations, its incidence and associated factors in critically ill adults remain uncertain because of diagnostic heterogeneity and the frequent clinical overlap with delirium. The aim of this study was to assess the prevalence of OWS and to identify factors associated with its development in adult patients. We conducted a retrospective, descriptive, observational study including patients evaluated at the post-ICU follow-up clinic of Lozano Blesa University Clinical Hospital (Zaragoza, Spain) over a 12-month period. This study investigated the association between multiple opioid medications and adjunctive medications and the occurrence of OWS. Eligible patients had an ICU stay of >7 days, received mechanical ventilation for >48 hours, and had been exposed to opioids. Demographic, clinical, and pharmacological variables were collected, including types of opioids, weight-adjusted cumulative dose, and use of adjuvant medications. OWS was diagnosed during the first 48 hours after opioid discontinuation using a combination of the Clinical Opiate Withdrawal Scale (COWS) and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria. Receiver operating characteristic (ROC) curve analyses were performed to evaluate the impact of morphine exposure. A total of 66 patients were included (mean age 59.9 ± 13.6 years; predominantly male). The leading cause of ICU admission was respiratory disease (48.5%). Mean Acute Physiology and Chronic Health Evaluation II (APACHE II) score at admission was 17.0 ± 6.1, and median ICU length of stay was 19 days. Twenty-two patients (33.3%) developed OWS, which was mild in 90.9% and moderate in 9.1% according to the COWS. No significant differences were observed between groups in baseline characteristics or delirium occurrence. Patients who developed OWS were more likely to have received morphine (100% vs. 75%; p = 0.010) and had a higher weight-adjusted cumulative morphine dose (3.15 ± 2.33 vs. 2.21 ± 2.50 mg/kg; p = 0.047), whereas no differences were found for fentanyl exposure. In addition, they more frequently required benzodiazepines (68.2% vs. 18.2%), neuroleptics (68.2% vs. 6.8%), and dexmedetomidine (31.8% vs. 4.5%) (p < 0.01 for all comparisons). Cumulative morphine dose showed modest discriminatory performance for OWS (area under the curve (AUC) 0.653; p = 0.048). OWS is a common complication among adult ICU survivors, although it is predominantly mild in severity. A higher cumulative dose of morphine was associated with its onset, although no association was found with the total duration of exposure. Clinical overlap with delirium and the reactive use of psychoactive medications may contribute to under-recognition of this condition, underscoring the need for structured OWS screening during ICU stay and in post-intensive care syndrome (PICS) follow-up.

PMID 42928669
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PubMedAnesthesia and analgesia2026-10-26

Influence of Preoperative Virtual Reality on Preoperative State Anxiety in the Ambulatory Setting: The AMBLUMEEN Randomized Controlled Trial.

Vacheron Charles-Hervé CH, Denis Angelique A, Bin Sylvie S, Rabilloud Muriel M et al.

Preoperative anxiety affects 30% to 80 % of ambulatory surgery patients and is associated with increased anesthetic requirements, postoperative pain, and delayed recovery. Virtual reality (VR) is a promising nonpharmacological anxiolytic, but evidence remains limited in the ambulatory setting. The AMBLUMEEN (AMBulatory LUMEEN) trial is a single-center, randomized, open-label, superiority trial conducted in an adult ambulatory surgery unit. Patients with moderate-to-severe preoperative anxiety (State-Trait Anxiety Inventory Form Y-A [STAI-YA] > 45) were randomized 1:1 to standard care alone (control) or standard care and a single 20-minute preoperative VR session (immersive 360° natural contemplative scenes). The primary end point was the change in STAI-YA score from arrival in the ambulatory unit (baseline) to immediately before operating room transfer (presurgery), analyzed under the intention-to-treat principle with a linear mixed model. Secondary end points included preoperative benzodiazepine use, postoperative morphine requirement, unplanned overnight admission, patient satisfaction, and device acceptability. Of 106 randomized patients (53 per group) with a median [interquartile range] baseline STAI-YA of 49 [46-55] and 49 [46-58] respectively in the control and VR group, the VR group experienced a markedly greater reduction in state anxiety than controls. Adjusted mean between-group difference in STAI-YA change from baseline to presurgery was -18.7 95% confidence interval (CI) [-21.4 to -16.1] points in favor of VR. Although benzodiazepine requirement, postoperative pain, and unplanned overnight admission were comparable between groups, the morphine requirement in postanesthesia care unit was lower in the VR group (6/53 [11.3% 95% CI, 11.3 {4.3-23.0}] vs 0/53 [0.0%, 95% CI, {0.0-6.7}]; P = .027). Global perioperative satisfaction was high in both groups (median 8 [8-9] on 10). A single 20-minute session of medical-grade VR significantly reduced preoperative anxiety in ambulatory surgery patients, with high acceptability and an excellent safety profile.

PMID 42929532
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PubMedJournal of pediatric orthopedics2026-10-26

Tractionless Hip Arthroscopy in Children With Suspected Septic Arthritis of the Hip: A Comparative Cohort Study.

Jamnik Adam A AA, Wilkens Colby R CR, Tareen Naureen G NG, Jo Chan-Hee CH et al.

Tractionless hip arthroscopy has emerged as a portal-based alternative to traditional open arthrotomy for children requiring operative treatment for suspected septic arthritis of the hip. However, comparative clinical outcome data remain limited. The purpose of this study was to compare outcomes following tractionless hip arthroscopy and arthrotomy in children undergoing operative treatment for suspected septic arthritis of the hip. We performed a retrospective cohort study of children who underwent operative irrigation and drainage for suspected septic arthritis of the hip between 2009 and 2025. The choice of operative approach reflected surgeon preference and increasing institutional experience with tractionless hip arthroscopy over the study period. Demographic characteristics, disease severity, operative variables, and postoperative outcomes were compared using unadjusted univariate analyses. A total of 164 children underwent operative treatment, including 34 treated with tractionless hip arthroscopy and 130 treated with arthrotomy. Children treated arthroscopically had higher initial inflammatory marker values and more frequent contiguous osteomyelitis. Operative time, hospital length of stay, repeat surgery, emergency department return, hospital readmission, and observed sequelae during available follow-up did not differ statistically between groups. The mean 48-hour C-reactive protein change was -2.7±6.7 mg/dL after arthroscopy and +0.23±6.0 mg/dL after arthrotomy (P=0.005); postoperative oral morphine equivalents were 12.9±22.1 and 28.6±55.2, respectively (P=0.020). These unadjusted secondary findings were considered exploratory. Tractionless hip arthroscopy was feasible and was not associated with an obvious increase in short-term treatment failure in this exploratory cohort. The findings do not establish equivalence, superiority, or long-term comparative safety. Prospective multicenter investigation with longer follow-up is warranted. Level III-retrospective cohort study.

PMID 42929217
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PubMedJournal of palliative medicine2026-10-25

Substituting Hydromorphone for Morphine in Medical Aid in Dying: Clinical and Practice Implications.

Mason Kerri L KL, Podewils Laura J LJ, Stein Samantha J SJ, Long Jeremy A JA

A morphine shortage in 2024-2025 led Medical Aid in Dying (MAiD) prescribers to substitute hydromorphone for morphine. To evaluate associations between substitution and time to death and sleep among patients supported by Denver Health's MAiD program, which serves Colorado. Quasi-experimental pre-post study of patients between January 2024 and February 2026 with verified ingestion, time to sleep, and time to death. Kaplan-Meier and Cox proportional hazards models compared time to death and sleep. Among 83 patients, median time to death did not differ between hydromorphone and morphine (55 vs. 65.5 minutes; p = 0.29). Median time to sleep was shorter with hydromorphone (3 vs. 5.5 minutes; p = 0.0007). After adjusting for age, hydromorphone was associated with a twofold faster time to sleep (adjusted hazard ratio 2.08, 95% CI: 1.29-3.36). Hydromorphone was associated with shorter time to sleep than morphine, with no significant difference in time to death. Further study should assess its use as an alternative to morphine.

PMID 42927983
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PubMedBehavioural pharmacology2026-10-25

Reciprocal blockade of the opioid and D2-like dopamine receptors in the nucleus accumbens modulates the pain-related behaviors in an animal model of inflammatory pain.

Khodabakhsh Helia H, Ghalandari-Shamami Mohadeseh M, Barikrow Nooshin N, Yekta Batool Ghorbani BG et al.

Studies showed that dopamine and opioid systems in the brain have essential role in the modulation of pain perception. The evidence indicated that in the nucleus accumbens (NAc), both dopamine type 2 (D2) receptors and opioid receptors are highly expressed. However, the interaction of these systems in NAc was not investigated in the modulation of inflammatory pain. One hundred twenty-six adult male Wistar rats received unilateral microinjections of different doses of morphine (2.5, 5, 10, and 25 mmol/0.5 μl) and quinpirole (8, 16, and 32 mmol/0.5 μl) to assess their effects as opioid and D2-like receptor agonists in the NAc. In the next step, the rats were administered varying doses of sulpiride (3, 6, 12, and 24 mmol/0.5 μl), a D2-like receptor antagonist, before an effective dose of quinpirole (32 mmol/0.5 μl). They also received naloxone (1.5, 5, and 15 mmol/0.5 μl) before the same effective dose of quinpirole (32 mmol/0.5 μl). The formalin test was employed to evaluate their inflammatory pain thresholds. Results indicated that intra-accumbal administration of morphine- and quinpirole-induced antinociceptive responses. However, sulpiride significantly diminished these responses. Naloxone also reduced the quinpirole's antinociceptive effects. Interestingly, sulpiride was less effective in reversing the analgesic effects of morphine (η2 = 0.17 in the first phase and η2 = 0.37 in the late phase) than naloxone in reversing the quinpirole's analgesic effects (η2 = 0.4 in the first phase and η2 = 0.53 in the late phase). These findings suggest an interaction between the opioidergic and dopaminergic systems in pain relief.

PMID 42924872
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