Morphine, Duramorph, MS, MSO4

Question 1

Morphine Class

Answer 1

• Narcotic Analgesic
• Opiate
• Schedule II Controlled Substance

Question 2

Morphine Action

Answer 2

• Decreases pain
• Morphine is a potent µopiate receptor agonist.
• Peripheral vasodilation
• Increasing venous capacitance
• Decreases venous return (chemical phlebotomy)
• Depresses the responsiveness of alpha-adrenergic receptors.
• Decreases both preload and afterload
• Decreases myocardial oxygen demand.

Question 3

Morphine Indications

Answer 3

• Moderate to Severe Pain
• Pulmonary Edema
• Acute Coronary Syndromes

Question 4

Morphine Contraindications

Answer 4

• Hypovolemia
• Hypotension
• Hypersentivity
• Head injury
• Patients who have taken MAOI within 14 days

Question 5

Morphine Precautions

Answer 5

• Respiratory depression
• Severe heart disease
• Geriatrics
• Hepatic/Renal disease
• Pregnancy (C) (increases to D if used for prolonged periods or high doses close to term)
• May worsen bradycardia or heart block in inferior MI (vagotonic effect)
• Use with caution in patients with unstable angina.

Question 6

Morphine Dosage

Answer 6

Adults:
• IV/IM/IO: 0.1 mg/kg initial dose (Max initial dose 10 mg)
• Give slowly over 2 minutes
• May repeat every 10 min as needed at 0.05 mg/kg
• Max total dose 20 mg
Pediatrics:
• IV/IO/IM: 0.1 mg/kg initial dose (Max initial dose 5 mg)
• Give slowly over 2 minutes
• May repeat every 10 min as needed at 0.05 mg/kg
• Max total dose 15 mg

Question 7

Morphine Onset/ Duration

Answer 7

• Onset: IV–3-5 min. IM, SubQ–15-60 min.

* Duration: 3-7 hours

Question 8

Morphine Side Effects

Answer 8

• Dizziness
• Altered L. O. C.
• Hallucinations
• Euphoria
• Mental impairment
• Hypotension
• Lightheadedness
• Bradycardia, Tachycardia
• N/V
• CNS Depression
• Respiratory Depression

Question 9

Morphine Interactions

Answer 9

• CNS depressants may enchance effects (antihistamines, antiemetics, sedatives, hypnotics, barbiturates, and alcohol
• MAOIs may cause paradoxical excitation