For a long time, the cancer patients have been subjected to severe pains at some stages of their illness and especially during the last days of their life. This has resulted to the search of a solution to the prolonged suffering of these patients. Over many years, the use of several methods resulted to a variety of results. These patients suffer particularly from difficulties in breathing coupled with a lot of pain: a condition commonly known as Dyspnea. This was the major reason for the use of morphine as a nebulizing agent in the treatment of the cancer patients, who experienced severe pain in the course of their treatment.
The use of morphine and the degree of effectiveness has proven to be to the patients to whom it was administered, however, has experienced a wave of criticism from a section of the public, who feel that it should not be completely adopted due to its side effects on the patients. This paper examines how morphine works on the receptors in the lungs. It also addresses such issues as the benefits, the cost and the side effects brought about by the use of morphine as a nebulizing agent in treatment.
Cancer Pain Management
The pain associated with the advanced stages of cancer patients is very severe and in some cases unbearable. Research has established that an average of 86% of the cancer patients wills eventually succumb to the disease. This is a very big number that cannot be taken for granted.
Other than the shortening of breath being the main cause of the pain experienced by these patients, some other causes of suffering include the numerous surgeries that are conducted during the treatment of the patients. An approximated number of 75% of the cancer patients at the advanced stages of disease experience severe pain (Apolone et al. 28).
The good news, however, is that about 90% of these pains are manageable through the application of drugs such as morphine.
Mode of Application
Morphine is administered to cancer patients orally for those, who are capable of swallowing. Due to the bitter taste associated with morphine, it is mixed with the food that is then given to the patients, who find it hard to deal with the bitter taste. For the advanced cases of cancer, which involves the patients who are no longer capable of receiving the tablet orally, morphine is administered through direct injection into the blood stream.
For oral administration of morphine, the drug exists in tablets that can either be taken directly or crashed into a powder form depending on the preference of the patient. The morphine contains an approximate measure of 0.5 milligrams of pentahydrate in every milliliter of morphine. The other component of morphine is usually sodium chloride, which accounts for about 9 milligrams in every milliliter of morphine.
Effect of Morphine on Receptor Cells of the Lungs
The solution retrieved from morphine usually is void of any form of bacteriostat or any antioxidant. A single dose of injection of this solution to a patient usually delivers analgesia through a path of intravenous as well as the epidurals or even through the intrathetical.
The effects of morphine are mostly concentrated on various receptor cells in the body of these patients, including the central nervous system as well as most of the tissues in the various organs of the body that are characterized as smooth tissues. For the cancer patients, the receptor cells in the lungs are one of the major areas that receive the effect of morphine administration directly. These receptors are usually located on the upper surface of the lung lining.
The receptor cells in the lungs and in other tissues of the body are widely known as the “u receptors”. Even though the lungs and other organs in the body hold a very large share of the receptor cells, the vast majority of them are located in the central nervous system where they are distributed in areas such as the thalamus, the hypothalamus and other sites of the brain. The spinal cord also contains a great number of the receptor cells.
These receptors provide a site for binding with the chemicals present in morphine to give the desired result, as well as the undesirable effects of morphine. These receptor cells due to their various properties speed up the effect of morphine and are the focal point of the administration of this drug as a pain reliever for the patients in their advanced stages of cancer therapy. They result to the effect of the morphine to be felt as soon as 15 minutes have elapsed from the time of administration to the patient. Most of the opioids including morphine play the role of the agonist as they undergo the process of binding with the receptor cells of the brain as well as the organ tissues.
When morphine is administered exogenously, it goes forward to play its role and delivers its analgesic effect by changing the common releases from the neurotransmitters from those that are sensitive to the nerve control to those that react commonly, according to stimuli. As a result, some effects such as excruciating pain, which is normally experienced by these patients due to the shortening of breath, is usually reduced to a minimum level.
The strong feeling of pain is usually first received by the vast network of nerve cells in the receptor cells. It is then transmitted to the central nervous system of the brain, which interprets it as pain, and this is felt in the various organs of origin of the transmission nebulizer morphine that acts by reducing the transmission of the pain by the receptor cells and thus the pain is not easily felt by the patient.
The transmission of the autonomic reflexes of the nervous system is not directly influenced by the administered morphine. However, morphine usually triggers some effects also known as spasmogenic. These are directed to the gastrointestinal channel and eventually lead to a reduction of the peristaltic effect, which causes contraction of the muscles as well as the tremors in the muscle, which are constant source of severe pain for the cancer patients, who are in the advanced stage of cancer therapy.
The influence of the sulfate component of morphine on the central nervous system is further driven by the capacity of this drug to cross through the barrier that exists between the brain and the blood. These sulfates are able to by-pass this boundary and offset their effect from the blood, in which they are contained, to the nerve system in the brain.
The use of morphine to treat the late stages of cancer has been of significant help to these patients. Even though a variety of people in the society dispute the use of morphine and other narcotic drugs such as medical marijuana, cocaine and other opioids, the best chance that these people have towards a bearable life is the use of these drugs. The drugs have many side effects but the relief they give the patients is impressive enough to justify their use. As a result, the use of morphine can be based on humanitarian grounds as compassion is one of the key attributes in the medical fraternity. The patients normally encounter agonizing pain due to the variety of factors. Some of these include the pain from the multiple surgeries that the cancer patients undergo so as to remove the malignant tumors. The other cause of the pain is associated with the difficulty arising from shortness of breath. These two factors result in severe pain and the best chance the patients have in reducing these pains is the use of morphine as well as other opioids. The advanced stages of cancerous pain do not respond to even the strongest painkillers in the medical laboratories.
Even though there might be other proffered methods of treating cancer patient that prove to be of more rewarding results than the use of morphine, none of these methods solve the issue of pain encountered by these patients. The freedom of choice should be exercised as some of the patients prefer the use of morphine to treat the agonizing pain they undergo. The best thing that the medical team can do is to advise the patients on the various treatment options they have as well as all the benefits and side effects associated with these methods of treatment. The final decision should be left to the patient as he or she is the principal victim.
The use of morphine to treat the cancer patients has also proven to be of rewarding benefits in term of mood alleviation for the cancer patients. These patients are known to experience mood improvements after morphine has been administered to them. Even though there are people arguing that treatment with morphine can eventually lead to depression, there is no proof that morphine is the actual cause of the depression. Other factors, such as the possibility of the imminent death, could be the reason for the depression.
However, the effect of analgesia is not normally felt at the instance of application. There is a period of delay of about 15 minutes before the onset of the effect of nebulized morphine on the cancer patients. The cause of this delay is the low solubility associated with morphine after the intrathecal, as well as the epidural, injection.
The other reason for the delay experienced after the administration of morphine is its tendency for a slower access towards the sites where the receptor cells are located. As result, the pain effect may persevere for a little longer until the analgesia effect reaches its full adoption. However, once the effect has been taken into the central nervous system, it will be retained for a very long period depending on the type of morphine that has been administered.
A very small dose of morphine can last up to a minimum of 4 hours while still having its effect felt by the patient. Better still, some morphine applications last a maximum of 12 hours (Husic & Ljuca 200). The chemical composition of morphine is the main cause of the long-term effect it has. They contain some hydrophilic components, which aid in the retention of the morphine in the central nervous system and slow release into the circulation system thus achieving an effect that is more prolonged (Jales et al. 112).
Side Effects of Morphine as a Nebulizing Agent
Various institutions conduct research to weigh the advantages to the disadvantages regarding the use of morphine. These organizations have conducted research on other opioids that are aimed to reduce the pain for cancer and hospice patients.
The results suggest that even though the use of morphine to reduce pain has widely been prescribed by most medical institutions, its side effects compel a closer examination and search for alternative treatment methods. One of these researches produced evidence linking the use of morphine, as well as other opioids to the increase the growth of cancerous cells. This has led to the conclusion that the use of opioids can stimulate cancerous cells to grow faster, and as a result lower the life expectancy of a patient.
The research also found out that morphine and other narcotic drugs are commonly involved in the hastening of death among the patients, who receive it as a therapeutic treatment. Due to application of the drugs and subsequent growth of opioids receptor cells, there is a reduction of the life expectancy of a patient (Flemming 64).
The patients, who received the alternative form of treatment that involved the use of drugs that prevented opioids sensitivity, developed some mutations that protected them from this sensitivity. As a result, they survived for a longer period of time than their counterparts who received morphine treatment.
The studies found out that there were a larger number of receptor cells for the patients who received their treatment with morphine and other opioids, as compared to the patients who received treatment that prevented their sensitivity to opioids (Krc%u030Cevski-S%u030Ckvarc%u030C 212)
The revealed number of these receptor cells is in a progressive trend in the lungs, as well as other organs that developed cancerous cells. The use of morphine can result to an addiction especially considering that it is a narcotic drug with a very high tendency for addiction.
Some patients have developed a great psychological overdependence on the morphine after a long period of usage. The use of morphine can also result to tolerance in which case the current level administered to the patient becomes none-effective and consequently higher doses need to be applied. This alone can be a major cause for addiction.
Physical dependency is a situation, in which the body becomes withdrawn in the case, where the application of the drug is suddenly stopped. It is another threat posed by the use of morphine as a therapeutic drug. The patients, who develop physical dependant addiction or tolerance, may need the help of a professional through a long period to overcome these effects. Some situations involve allergic reactions of patients if there is the use of morphine and other narcotic drugs due to the production of a chemical known as histamine (Flemming 98).
Other common side effects associated with the use of morphine and other opioids in the treatment of the shortening of breath for cancer patients include constant vomiting as well as nausea. These effects come about by the stimulation effect caused on the zone that triggers chemoreception. Other side effects include diarrhea, seizures, hallucinations, fainting, blurred vision, skin rashes as well as throat tightness that causes swallowing hardship.
Cost of Using Morphine
Research suggests that the use of morphine is more cost-effective that alternative methods of treating patients in severe pains at the advanced stages of cancer. The cost of using administered morphine with implantable pumps is much lower than that of using alternative treatment methods. Research reveals that the use of the implantable pumps for treatment can sustain a patient for a range of 12 to about 18 months more than the use of alternative methods.
However, this estimate is used when the consideration of the cost of replacing the implantable pumps is not taken into account. These lower costs together with the effectiveness demonstrated by the use of morphine have made it one of the most suitable treatment methods for cancer patients.
However, further analysis brings out the fact that even though the cost of treatment of cancer patients may be lower than that of using alternative methods of treatment, the net cost may be surprisingly higher than the expected cost. This is because the implantable pumps may have to be replaced constantly and considering their higher cost, they may even double the estimated expenses.
Addiction to the drug is one of the major causes of the increase in the cost. Patients, who get addicted to the opioids, may need to be taken to the rehabilitation centers, where they can spend a lot of time depending on the level of addiction. This will eventually lead to an increase in the price of treating a single patient, as the cost of rehabilitation is very high. The good news, however, is that there are insurance companies that cater for the cost of morphine rehabilitation and thus the cost can still be lower.
The cost of using morphine to the point of addiction is viewed on a wider scope rather than just the monetary portion. This is because addiction to morphine may lead to the loss of some of the most important relationships that a person has built over a long period.
This may be caused by the snit-social behaviors that a person develops due to addicting, such as withdrawal from the community; a person becomes more and more obsessed with satisfying his drug addiction.
Other cause of an overshooting of this cost may result from the development of tolerance to this drug by the patient. In such a case, the amount of morphine used to relieve the pain encountered by the patient may have to be increased further. This will eventually increase the cost of treatment depending on the level of tolerance developed. Overdependence on the drugs to such level of displaying withdrawal symptoms may also lead to the increase of the use of the drug and growth of the cost of treatment as well (Flemming 105).