Morphine Sulfate Flashcards
Drug Classification
Narcotic analgesic
What is its 2nd Action?
Depresses CNS by interacting with opiate receptors in the brain
What is its 1st action?
Decreases pain perception & produces euphoria
What is its 3rd action?
⬇️ ❤️ O2 demand by:
- ⬇️ Preload by peripheral vasodilation causing venous pooling & ⬇️ venous return
- ⬇️ Afterload by peripheral vasodilation causing ⬇️ systemic vascular resistance
1st Indication
Moderate to Severe Pain
esp. Burns and fractures
2nd Indication
CP of myocardial origin
3rd Indication
Pulmonary Edema
Not in LA
Contraindications?
- Hypotension
- ⬆️ ICP - Head injury
- Pt’s at risk for Respiratory Depression (rate
Adverse Effects
CARDIO-tachy, brady, hypotension RESP- bronchospasm, depression, apnea NEURO- sedation-aloc, dizziness, agitation, tremors/seizures, hallucinations, blurred vision G/I- n/v OTHER- itching, flushed skin
Administration
Pain Control
2-10mg slow (2mg/min) IVP
Titrate to pain relief
May repeat IVP dose prn to max. 20mg
5-10mg IM single dose, no repeat
PEDS
0.1mg/kg slow (1mg/min)
Titrate to pain relief
0.1 mg/kg IM single dose, no repeat
Onset
2-5 min. IVP
5-30 min. IM
Duration
3-4 hours
What other drug should be available and why?
Naloxone
Reverse resp. depression caused by morphine
Why does morphine cause hypotension?
Histamine mediated hypotension
Volume depleted
Right Ventricular MI
Use caution for these patients:
Sudden onset headache
Active Labor
Elderly
ETOH/Drugs
How can morphine be mixed?
Mix 10mg (1mL) w/ 9ml of NS
To produce a concentration of
1mg / 1mL
How is Morphine supplied?
4mg vial
10mg in 1 mL vial, pre-filled syringe or ampule
What schedule is Morphine
Schedule II
Reference #806
Isolated extremity injury/burn
Moderate to Severe pain
2-4mg slow IVP. Titrate to relief.
May repeat one time.
PEDS: 0.1mg/kg slow IVP
NO REPEAT
Max total dose 4mg
Reference #806
Crush injury
2-12 mg slow IVP. Titrate to pain relief.
Max dose total 20mg
PEDS: 0.1mg/kg slow IVP
NO REPEAT
Max dose total 4mg
