Morphine Flashcards

1
Q

Presentation

A

10 mg in 1 mL

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2
Q

Pharmacology - CNS effects (DDDRS)

A
Depression (leading to analgesia)
Depression of cough reflex
Dependence (addiction)
Respiratory depression
Stimulation (mood changes, euphoria or dysphoria, vomiting, pin-point pupils)
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3
Q

Pharmacology - Cardiovascular effects

A

Vasodilatation

Decreases conduction velocity through AV node

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4
Q

Metabolism

A
Metabolised = liver
Excreted = kidneys
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5
Q

Indications

A

Pain relief

Sedation to maintain intubation

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6
Q

Contras

A

Hypersensitivity
Renal impairment/failure
Late second stage labour

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7
Q

Precautions

A
Elderly/frail
Hypotension (cardiovascular effects)
Respiratory depression (CNS effects)
Current asthma (CNS effects)
Respiratory tract burns (CNS effects)
Known addiction to opioids (CNS effects)
Acute alcoholism
Patients on monoamine oxidase inhibitors
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8
Q

Route of administration

A

IV
IM
Subcutaneous

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9
Q

Side effects - CNS

A
Drowsiness
Respiratory depression
Euphoria
Nausea, vomiting
Addiction
Pin-point pupils
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10
Q

Side effects - Cardiovascular

A

Hypotension

Bradycardia

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11
Q

IV effects

A
Onset = 2-5 mins
Peak = 10 mins
Duration = 1-2 hrs
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12
Q

IM effects

A
Onset = 10-30 mins
Peak = 30-60 mins
Duration = 1-2 hrs
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13
Q

Moderate Pain - Adult

A
Up to 5mg IV
Repeat up to 5mg IV @ 5min intervals
Max dose 20mg IV
Consult for more
Consider Paracetamol as per mild pain in combination
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14
Q

Severe Pain - Adult

A

As per moderate pain
Consider IN Fentanyl or Methoxyflurane
Consult for IV Ketamine for extreme traumatic pain
Last resort elderly/frail/ <60kg - IM Morphine 0.1 mg/kg single dose
Last resort adult - IM Morphine, 10mg IM, repeat 5mg IM after 15mins, once only.

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15
Q

Paediatric pain relief

A

Last resort ONLY when unable to administer IN/IV Fentanyl
0.1mg/kg IM single dose only
Max dose should not exceed 5mg (unless pt heavier then age calculated weight).

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16
Q

Preparation for administration

A

10 mg in 1 mL
Dilute with 9 mL Normal Saline in a 10 mL syringe
= 1 mg in 1 mL