Morphine

Question 1

Therapeutic Classification

Answer 1

Narcotic Analgesic

Question 2

Pharmacologic Classification

Answer 2

Opioid Agonist

Question 3

Pregnancy Category

Answer 3

C

Question 4

Mechanism of Action

Answer 4

o occupies mu and kappa receptor sites in the brain and dorsal horn of spinal cord that alter release of afferent neurotransmitters.
o Alters perception of an emotional response to pain.
o Produces analgesia and euphoria
o Mimics actions of endogenous enodorphins

Question 5

Indications

Answer 5

o Acute and severe chronic pain

o Relieving acute MI

Question 6

Contraindictions

Answer 6

o	Hypersensitivity (pts with hypersensitivity to opioids)
o	Premature Infants

Question 7

Precautions

Answer 7

o	Elderly
o	Undiagnosed abdominal pain
o	Hepatic/renal impairment
o	Shock
o	CNS depression
o	Head injury/Increased ICP
o	COPD

Question 8

Drug Interactions

Answer 8

o CNS depressant: Increased sedation including alcohol, skeletal muscle relaxers, MAOIs
o Reversed affect with opioid antagonist – naloxone
o Additive constipation with antidiarrheal

Question 9

Adverse Effects

Answer 9

o CNS depression
o Respiratory depression: increase CO2 produces vasodilation and increases CSF pressure
o Constipation, nausea, vomiting
o Urinary retention
o Sedation, dizziness, anxiety, disorientation
o Orthostatic hypotension
o Pruritus with IV or epidural route

Question 10

Schedule II narcotic

Answer 10

schedule II narcotic

Question 11

nursing responsibility

Answer 11

o Complete assessment, including pain scale
o Assess respiratory function
o Monitor vital signs
o Monitor for respiratory depression, hypotension, CNS effect
o Prevent constipation, monitor I&O
o Evaluate effectiveness