Oxycodone vs. Morphine

I work in a residential hospice and am comfortable with opioid dosing and most equianalgesic conversions. Lately, I am seeing more oxycodone/Oxycontin prescribed as opposed to when I started with hospice and the gold standard opioids for pain and dyspnea were morphine and MSContin. Of course, we see a fair share of Dilaudid, Fentanyl, Methadone, hydrocodone, etc.

Does anyone know of any information out there about the relative efficacy of morphine vs. oxycodone for pain and dyspnea? Anecdotal reports would be fine, but I'm looking for some solid research as well, including the differences in the method of action of the two drugs.

Thanks!

if you go to google and type in morphine vs. oxycodone efficacy, then i am confient you will find the answer you are seeking.

good luck.

leslie

And your drug actions are in any good standard med book.

Thanks for the replies. I haven't found what I'm looking for in any of the Google entries, though - a specific comparison of the efficacy of morphine and oxycodone in treating pain and dyspnea. I'm finding lots of conversion information and relative strengths, but nothing comaparing the efficacy of just those two drugs in a trial.

As far as the drug actions, what I'm looking for is the specific opioid receptors that the respective drugs target. I'm not finding that in the drug books, but I'll keep looking!

Thanks again. :)

Thanks for the replies. I haven't found what I'm looking for in any of the Google entries, though - a specific comparison of the efficacy of morphine and oxycodone in treating pain and dyspnea. I'm finding lots of conversion information and relative strengths, but nothing comaparing the efficacy of just those two drugs in a trial.

As far as the drug actions, what I'm looking for is the specific opioid receptors that the respective drugs target. I'm not finding that in the drug books, but I'll keep looking!

Thanks again. :)

hey katillac,

i honestly don't think you'll find specific opioid receptors as it's still relatively unknown on how narcotics work.

i had to do a paper on narcotics and what i found out wasn't a heck of a lot, again because very little is known about the mechanism of narcs.

good luck,

leslie

http://www.docguide.com/dg.nsf/PrintPrint/E407ABEE2163BEBA85256E53007A1E0C

http://www.jco.org/cgi/content/abstract/16/10/3222

http://jpet.aspetjournals.org/cgi/content/abstract/295/1/91

Thank you so much, aimee. These are perfect.

Also, Wikipedia's articles on both drugs mention multiple studies referring to receptors as well as metabolizing.

A big problem that most people have with morphine based medications as opposed to codeine based ones is that morphine makes people VERY drowsy in comparison, and also has a higher risk of dependency.

My research area is dyspnea.

Morphine has been shown to be effective at relieving dyspnea across at least 5 rcts. Current American College of Chest Physicians guidelines recommend using morphine for dyspnea (along with other non pharma interventions). It is currently hypothesized that morphine acts on the breathing center in the brain to relieve th subjective sensation dyspnea. The mechanism of action is not known.

To the best of my knowledge, oxycodone has not been studied for dyspnea relief. Morphine remains the gold standard of treatment for end stage Dyspnea.

I currently use google scholar to look up papers quickly. It is much better than pubmed or plain google. Go to google, then google scholar- us the terms Dyspnea AND morphine and you will get a nice stack o journal articles.

I find that oxyfast works great for dyspnea in hospice pts. However, we reserve it for pts who are either allergic/intolerant to roxanol or the roxanol is no longer effective for them.