Morphine, Fentanyl, Ondansetron Flashcards
Morphine classification
Opiate, narcotic analgesic
Morphine trade name
Duramorph, astromorph
Morphine desired effects
Potent analgesic; CNS depressant; causes peripheral Venus dilation
Morphine mechanism of action
Binds to opioid receptors in the CNS. Decreases pain transmission
Morphine indications
Severe pain i.e. fractures, kidney stones, burns
Acute myocardial infarction
Morphine contraindications
Respiratory distress / depression
Head injury
Bronchospasm or asthma
Hypovolemic shock
Morphine Adverse reactions
CNS depression
Respiratory depression / apnea
Bradycardia
Nausea / vomiting
Morphine precautions
Naloxone ready for overdose or toxicity
More pronounced effects in elderly patients
Morphine adult dosing
2- 5 mg slow IV push every 5 minutes max 10 mg
Morphine pediatric dosing
0.1 mg / kilogram slow IV push repeat every 5 minutes. Max dose 10 mg
Fentanyl classification
Opiate agonist
Fentanyl trade name
Sublimaze, Fentura
Fentanyl desired effect
Alter pain reception / increase pain threshold
Fentanyl mechanism of action
Binds to opiate receptors in the CNS reducing stimuli from nerve endings
Fentanyl indications
Severe pain
Pain and anxiety associated with CPAP
Fentanyl contraindications
Increased ICP
Severe hepatic or renal impairment
Respiratory depression
Asthma
Fentanyl adverse reactions
Drowsiness
Nausea / vomiting
Respiratory depression
Bradycardia
Fentanyl drug interactions
Amiodarone: profound bradycardia, sinus arrest, hypotension
Benzodiazepines, may increase risk of hypotension / respiratory depression
Fentanyl adult dosing
50 - 100 MCG IM, IN or slow IVP over 2-3 min
Fentanyl pediatric dosing
0.5 - 1 mcg/kg IM, IN or slow IVP
Ondansetron classification
Antiemetic
Ondansetron trade name
Zofran
Ondansetron mechanism of action
Is a selective five - HT3 receptor antagonist. Mechanism of action has not been fully characterized
Ondansetron desired effect
Prevent nausea and vomiting
Ondansetron indications
Nausea and vomiting
Ondansetron contraindications
Hypersensitivity
Ondansetron adverse reactions
Headache
Rare cases: chest pain and hypovolemia
Ondansetron adult dosing
4 mg slow IV push over 2- 5 minutes or 4 mg IM
Ondansetron pediatric dosing
Less than 40 kg
0.1 mg / kilograms slow IV push over 2-5 minutes; patients less than 40 kg
Ondansetron pediatric dosing
Over 40 kg
4 mg slow IV push over 2-5 minutes for patients over 40 kg
Can also give PO