Morphine Flashcards
What is morphine?
A strong opioid
What is the mechanism of action of morphine?
Full agonist for G-protein coupled receptors
What are the routes of delivery of morphine?
- PO
- IV
- IM
- SC
- PR
- Intrathecal
- Epidural
How does patient controlled analgesia (PCA) prevent overdose?
PCA has lock-out mechanism in place to prevent accidental overdose
What are the indications for morphine?
- Moderate to severe pain of acute or chronic nature
- Palliative treatment
What should you do before prescribing morphine for pain relief?
Escalate pain relief up the pain ladder
What is the purpose of morphine in palliative treatment?
To keep patient comfortable at the end of life
In what conditions are all opioids, including morphine, contraindicated in?
- Respiratory depression
- Head injury
- Raised ICP
- Patients at risk of paralytic ileus
In what conditions is morphine contraindicated in?
- Acute abdomen
- Delayed gastric emptying
- Heart failure secondary to chronic lung disease
- Pheochromocytoma
What can be used to monitor respiratory and CNS depression with morphine?
Sedation scores
What is the reversal agent for opioid-induced respiratory and CNS depression?
Naloxone
What might morphine interact with?
- CNS depressants, such as alcohol, sedatives, and anaesthetic agents
- MAOIs
What might happen if morphine is given with CNS depressants?
Increased risk of respiratory depression
What might happen if morphine is given with MAOIs?
Enhanced effects of morphine
What are the common side effects of morphine?
- Nausea and vomiting
- Constipation
- Urinary retention
- Itching
- Respiratory depression
- Hypotension
- Paralytic ileus
- Sedation
