Morphine Sulphate

Question 1

Pharmacology and presentation of Morphine?

Answer 1

10mg:1ml

Morphine is an opiate analgesic that acts on the central nervous
system by binding with opioid receptors, leading to CNS depression, resp depression, cough reflex depression, stimulation (mood, euphoria/dysphoria, vomiting) and potential for dependence. It also decreases the rate of AV conduction and can
precipitate vasodilatation.

Question 2

Indicators of Morphine?

• PAID

Answer 2

• Pain Relief
• Sedation for intubation (post-intubation, SFI and RSI)
• Autonomic Dysreflexia with SBP >160mmHg
• Dyspnoea in palliative patient with valid medical order.

Question 3

Contraindications of Morphine?

• L BAR

Answer 3

• Known allergy
• Renal impairment or failure
• Labour and post-partum
• Breastfeeding.

Question 4

Cautions of Morphine?

• REACH

Answer 4

• Elderly
• Hypotension
• Respiratory depression
• Known addiction to narcotics
• Concomitant Monoamine Oxidase Inhibitors (MAOI) therapy.

Question 5

Side Effects of Morphine?

• 5x Head, 2x Heart, 1x Lung

Answer 5

• Bradycardia
• Hypotension
• Drowsiness
• Respiratory depression
• Euphoria
• Nausea and/or Vomiting
• Pinpoint pupils
• Addiction

Question 6

Dosing Regimes of Morphine?

Answer 6

IM/SC
- Adults = 2.5-10mg IM/SC, repeat up to 5mg, 15 minutely to a max of 20mg
- Paed = 0.1mg/kg IM to a max of 5mg in a single dose, repeat dose 15 minutley to a max of 0.2mg/kg

IV/IO
- Adults = 2.5-5mg IV/IO, epeat up to 5mg, 5-10 minutely to a max of 30mg before consulting

Question 7

Onset and duration of Morphine?

Answer 7

• Onset = 2-5mins IV/IO or 5-10mins IM
• Duration = 1-2hrs