Respiratory Effects

Morphine acts directly on the respiratory centers of the brain stem and produces decreased minute ventilation by decreasing tidal volume. Respiratory depression is more likely with high doses of opioids. Respiratory depression is seen less with partial agonists/antagonists since they are mostly selective for kappa receptors. Morphine decreases the responsiveness to carbon dioxide, shifting the carbon dioxide response curve downward and to the right (Martin 1983). The cough center in the medulla can also be depressed with morphine (Grossman 1988). Naloxone is very effective in reversing respiratory depression quickly.

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