A 34-week infant born from a mother with a history of drug abuse developed neonatal abstinence syndrome (NAS) in the first hours of life. Urine drug screening was positive for cocaine and heroin. The infant developed acute kidney injury and bilateral hydronephrosis while receiving oral morphine for control of NAS. Cessation of morphine therapy and urinary catheterization resulted in a rapid and...

OBJECTIVES To compare the efficacy of continuous extrapleural intercostal nerve block with bupivacaine 0.5% in 1:200,000 epinephrine and continuous lumbar epidural block with morphine in controlling post-thoracotomy pain and to measure serum bupivacaine concentrations during extrapleural infusion. DESIGN A prospective, randomized, controlled trial. SETTING St. Joseph's Hospital, Hamilton, O...

QUESTION Recently a newborn died from morphine poisoning when his mother used codeine while breastfeeding. Many patients receive codeine for postlabour pain. Is it safe to prescribe codeine for nursing mothers? ANSWER When a mother is an ultrarapid metabolizer of cytochrome P450 2D6, she produces much more morphine when taking codeine than most people do. In this situation, newborns might be ...

A 34-week infant born from a mother with a history of drug abuse developed neonatal abstinence syndrome (NAS) in the first hours of life. Urine drug screening was positive for cocaine and heroin. The infant developed acute kidney injury and bilateral hydronephrosis while receiving oral morphine for control of NAS. Cessation of morphine therapy and urinary catheterization resulted in a rapid and...

Chronic breathlessness, a persistent and disabling symptom despite optimal treatment of underlying causes, is frightening with serious widespread impact on patients their carers. Clinical guidelines support the use morphine for relief chronic breathlessness in common long-term conditions, but questions remain around clinical effectiveness, safety longer-term (>7 days) administration. This tr...

Certain actions of doxapram, administered alone and in combination with morphine, have been examined in the rabbit and the mouse. Single doses of doxapram were capable of stimulating respiration in both species. There was an increase in tidal volume in the rabbit and an increase in respiratory rate in the mouse. In both species the duration of action of single doses of doxapram was less than 15...

Our group recently demonstrated in a rat model that pretreatment with morphine facilitates doxorubicin delivery to the brain in the absence of signs of increased acute systemic toxicity. Morphine and other drugs such as dexamethasone or ondansetron seem to inhibit MDR proteins localized on blood-brain barrier, neurons and glial cells increasing the access of doxorubicin to the brain by efflux t...