Morphine

Question 1

Pharmacology and presentation of Morphine?

Answer 1

10mg:1ml

Morphine is an opiate agonist (stimulator) that binds to opiate receptors in the CNS causing analgesia

Question 2

Indicators of Morphine?

Answer 2

• Symptom control during end of life care
• Where fentanyl is contraindicated due to an allergy and the patient has either: moderate to severe pain, CPO with severe anxiety, requires sedation post intubation

Question 3

Contraindications of Morphine?

Answer 3

• Known severe allergy
• Current respiratory depression
• Unable to obey commands unless given for symptom control in end-of-life care

Question 4

Cautions of Morphine?
3x age, 3 x down

Answer 4

• Elderly/frail
• Labour
• Age <1 years
• Patients at high risk of respiratory depression e.g. severe COPD, obesity or home ventilation
• Concurrent administration of other opiates, ketamine or midazolam
• Signs of shock

Question 5

Side Effects of Morphine?
Head down x 5

Answer 5

• Sedation
• Nausea & vomiting
• Hypotension
• Respiratory Depression
• Histamine release & itch

Question 6

Dosing Regimes of Morphine?

Answer 6

Morphine IV Adult
- 1-5mg IV, every 5mins prn for pain relief
- 1-2mg IV doses every 5mins (sparingly) prn for severe anxiety in CPO

Morphine IM Adult
- 5-10mg IM or SC, single dose, if IV can’t be obtained

Morphine IV Paediatrics
- 0.5mg per 10kgs, IV

Morphine IM Paediatrics
- 2mg per 10kgs, IM

Question 7

Onset and duration of Morphine?

Answer 7

Onset:
-IV = 2-5mins
- IM/SC = 5-10mins

Duration
- 30-60mins