Morphine is the prototypical strong mu agonist opioid and is still the most commonly used opioid worldwide. Orally administered morphine is available in both immediate acting and extended release formulations. A combination of both immediate acting and extended release morphine is typically used in chronic pain management. Morphine metabolites include morphine-3-glucuronide (hyperalgesia, agitation, myoclonus; can accumulate in renal insufficiency or prolonged high doses), morphine-6-glucuronide (more potent than morphine; can accumulate in renal insufficiency or prolonged high doses), and normorphine (allodynia, myoclonus).
Many opioids are available orally in extended release preparations. The most common are given below.
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