Morphine Sulfate

Question 1

Trade Name

Answer 1

None

Question 2

Class

Answer 2

Opioid analgesic (Schedule II narcotic)

Question 3

Mechanism of Action

Answer 3

Alleviates pain by acting on the pain receptors in the brain; elevates pain threshold; depresses brainstem respiratory centers; decreases responsiveness to changes in PaCO2; increases venous capacitance (venous pooling) and decreases venous return, vasodialates arterioles, reducing preload and after load; depresses ventral nervous system, blocking sympathetic response to decrease anxiety, fear, and histamine release

Question 4

Indications

Answer 4

Analgesia for moderate to severe pain

Question 5

Contraindications

Answer 5

Respiratory depression, hypotension, CHF/pulmonary edema, head injury, undiagnosed abdominal pain

Question 6

Adverse effects

Answer 6

Histamine release may cause local urticarial and hypotension, nausea, vomiting, respiratory depression, bonchospasms and bradycardia

Question 7

Incompatibilities/ drug interactions

Answer 7

Other CNS drugs can potentiate its effect. It can be reversed by Narcan

Question 8

Routes of admin

Answer 8

IV/IM

Question 9

Onset of action

Answer 9

Onset in seconds, peak effect of 20 min, duration of 2-4hrs

Question 10

Adult dose

Answer 10

2-10mg slow IVP

May repeat ever 5-15 minutes up to pain scale 2-3

Question 11

Pediatric

Answer 11

0.05-0.1 mg/kg slow IVP, may repeat in 15-20 min

Question 12

Special considerations

Answer 12

Use with caution in the geriatric population and those with COPD, asthma.
Narcan should be readily available as an antidote

Question 13

Protocols used

Answer 13

A-3; Altered mental status
A-22: Overdose
E-18: Intranasal Medication device
E-19: Sedation/Pain