Why the study?
Morphine decreases the bioavailability and antiplatelet effect of P2Y 12 receptor inhibitors, but adequately powered randomised trials examining the clinical consequences of their concomitant use are lacking.
Does morphine co-administration decrease the efficacy of P2Y12 receptor inhibitors in patients with acute myocardial infarction?
Does morphine co-administration decrease the efficacy of P2Y12 receptor inhibitors in patients with acute myocardial infarction?
Morphine decreases the bioavailability and antiplatelet effect of P2Y12 receptor inhibitors in acute MI, highlighting the need for alternative analgesic strategies or modified antiplatelet regimens.
Answers are grounded in this paper and cite their sources.
Morphine-P2Y12 interaction may blunt antiplatelet effect in AMI; leaves open optimal mitigation strategy.
Morphine is routinely used for pain relief in patients with acute myocardial infarction. However, it was documented that morphine decreases the bioavailability and antiplatelet effect of P2Y 12 receptor inhibitors. Multiple strategies to overcome this undesirable interaction are currently under investigation; they include the follwing: administration of crushed ticagrelor tablets, co-administration of metoclopramide, bridging with intravenous antiplatelet agents, or replacement of morphine with other analgesic. Adequately powered randomised trials examining the clinical consequences of concomitant use of morphine and P2Y 12 receptor inhibitors are still lacking.
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Ostrowska et al. (2020) studied this question.
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