morphine sulfate (ANALGESIC DRUG) Flashcards

1
Q

how is morphine sulfate presented on the road

A

Injection: morphine sulfate 10mg/ml (morphine sulfate 10mg per 1 ml)

Oral: morphine sulfate 10mg/5ml (morphine sulfate 2mg per 1ml)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are the indications for morphine sulfate

A

pain associated with suspected MI (morphine should be the first drug to be given)

severe pain- as part of an analgesic plan like with paracetamol

pt with continuous severe musculoskeletal and soft tissue pain.

oral morphine= helps with moderate pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what are the indications for end of life adults

A

if pt own medication for pain/breathlessness hasn’t been prescribed

pt own medication isnt availaible/run out

medicines are in place without a patient-specific document signed by independent prescriber

Breathlessness: pt is at end of life care and is distressed and breathless

if unable to access rapid community/palliative care

Pain: pt is at end of life care and is in pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is morphine sulfate classed as

A

strong opioid analgesic

morphine produces sedation, euphoria (happiness), and analgesia (can reduce rr and cause hypotension)

histamine is released causing vasodilatory effects. May also cause urticaria and bronchoconstriction.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are the pharmacokinetics of morphine sulfate

A

administration: parental/ enteral (including orally and IV)
distribution: plasma proteins
Metabolism: Liver
Excretion: Urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are the pharmacodynamics for morphine sulfate

A

Morphine binding to opioid receptors blocks the transmission of nociceptive signals.
Signals pain- modulating neurons in spinal cord
inhibits primary afferent nociceptors to dorsal horn sensory projection cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

possible adverse effects of morphine sulfate

A

reduced rr
reduced hr
nausea/vomiting
drowsiness
pupillary constriction
itching due to histamine being released

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

contra-indications for morphine sulfate

A

children under 1
rr under 10 for adults
rr under 20 for children
hypotension ( systolic bp below 90mmHg)
head injury (with only responsive to pain or unresponsive or below a 9 for GCS)
known hypersensitivity to morphine sulfate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are the contraindications for morphine sulfate in adult end of life care

A

cautions and contra-indications don’t generally apply due to the focus being on minimizing pain and breathlessness.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what factors need to be taken into account for dosage of morphine sulfate for adults

A

weight
age
route of administration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is the maximum dose of morphine sulfate for adults weighing over 50kg

A

20mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

how long does IV morphine take to work? and when does it reach its peak time

A

minimum of 2-3mins and reaches its peal at 10-20 mins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

should morphine be diluted? if so what with

A

should be diluyed with sodium chloride 0.9% to make concentration of 10mg in 10ml UNLESS being administered IM or subcutaneous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

when should morphine NOT be diluted

A

when being given IM or subcutaneous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

If pain isnt reduced to a tolerable level after 10mg of IV/IO morphine then how many mg of morphine should be administered

A

2 mg slowly via IV/IO every 5 mins to a maximum of 20mg.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

For end of life care in adults, what is the correct dosage for sub or oral use of morphine when they are currently on morphine

A

administer their prescribed dose.
if dose range given, administer lowest dose. in line with previous dose

17
Q

if end of life adult pt isnt on morphine whats the dosage for morphine orally

A

oral morphine should be given as 2.5mg—-> 5mg. only given once

18
Q

if end of life adult pt isnt on morphine whats the dosage for morphine IM//SUB

A

1mg—->2.5mg. only given once