Morphine Sulphate

Question 1

What is the dose of morphine in acute pulmonary oedema or MI?

Answer 1

10mg in 10ml iv, or 5mg of diamorphine

Question 2

What are some other indications for morphine?

Answer 2

Step up from stage 2 of the analgesic ladder

Morphine sulphate tablets, buprenorphine transdermal patches, oromorph to treat breakthrough pain

Question 3

Contraindications of morphine

Answer 3

Hypersensitivity
Do not deny analgesia in opioid abuse
Beware strong effect if opiate naiive

Question 4

Side effects of morphine

Answer 4

Respiratory depression
Nausea- must prescribe antiemetic with it
Hypotension
Constipation, ileus

Question 5

Which drugs interact with morphine?

Answer 5

Other CNS depressants/sedatives
Diuretics/antihypertensives - hypotension
Alcohol

Question 6

How is morphine eliminated?

Answer 6

Hepatic metabolism, excreted in bile/faeces
Half life 2-4 hours
Use small doses, or fentanyl in renal or hepatic impairment as can accumulate

Question 7

How does morphine work?

Answer 7

Opiate analgesic- controlled drug!

Mu-opioid receptor agonist in CNS and gut