Morphine

Question 1

Morphine

Class

Answer 1

• Opioid analgesic (Sched II)

Question 2

Morphine

Mechanism of action

Answer 2

• Alleviates pain through CNS action
• Suppresses fear & anxiety center in brain
• Depresses brain stem respiratory centers
• Decreases preload and afterload, which decrease myocardial O2 demand
• Increases peripheral venous capacitance and decreases venous return

Question 3

Morphine

Indications

Answer 3

• Severe CHF
• AMI
• Pulmonary Edema
• Analgesia for moderate to severe acute & chronic pain

Question 4

Morphine

Contraindications

Answer 4

• Head injury
• Exacerbatetd COPD
• Decreased respiratory drive or LOC
• Hypotension
• MAOI’s within 14 days
• Undiagnosed ABD pain
• Suspected hypovolemia

Question 5

Morphine

Adverse reactions

Answer 5

• Respiratory depression, bronchospasm
• Hypotension, Syncope
• Decreased LOC
• N/V
• Bradycardia
• Tachycardia
• Euphoria
• Facial flushing
• Drymouth

Question 6

Morphine

Drug interactions

Answer 6

• Potentiates sedative effect of phenothiazine
• CNS depressants may potentiate effects of morphine
• MAOI’s may cause paradoxical excitation

Question 7

Morphine

Dosage and administration

Answer 7

• Adult:
  
  • Initial dose: 2-4 mg IV over 1-5 min q 5-30 min
  • Repeat dose: 2-8 mg at 5-15 min intervals
• Peds:
  
  • 0.1-0.2 mg/kg per dose, IV, IM, SC
  • Max dose of 5 mg

Question 8

Morphine

Duration of action

Answer 8

• Onset: Immediate
• Peak Effect: 20 min
• Duration: 2-7 hrs

Question 9

Morphine

Special considerations

Answer 9

• Pregnancy: Cat C
• Rapidly crosses the placenta
• Safety in neonate not established
• Use with caution in geriatrics, COPD, & Asthmatic pts
• Vagotonic effect in pt with acute inferior MI
  
  • (bradycardia, heart block)
• Narcan should be available