Morphine

Question 1

What is the generic name of Morphine?

Answer 1

Morphine Sulfate Penahydrate

Question 2

What type of medication is Morphine?

Answer 2

An opioid analgesic.

Question 3

What are the actions of morphine?

Answer 3

• It decreases pain perception and anxiety.

Morphine binds to the delta, kappa, and mu opioid receptors of the peripheral and central nervous system. This activates the descending inhibitory pathways of the CNS, and inhibits the nociceptive afferent neurons of the PNS, leading to a reduction of the nociceptive transmission.

Morphine binds to the delta, kappa, and mu opioid receptors of the CNS/PNS. It activates the descending inhibitory pathways of the CNS, resulting in the activation of descending inhibitory neurons. It also directly blocks afferent (autonomic) nociceptive nerves in the periphery.

• It causes peripheral vasodilation, respiratory depression, bradycardia, sedation, nausea/vomiting, and decreased gut motility.

Question 4

What are the uses of morphine?

Answer 4

• Pain management and anxiety
• Post intubation sedation (6 months old or more only).

Question 5

What are the adverse effects of morphine?

Answer 5

• Decreased LOC
• Respiratory depression
• Hypotension
• Nausea & vomiting.

Question 6

What are the contraindications of morphine?

Answer 6

• Altered LOC (V, P or U with the exception of patients requiring post intubation sedation)
• Allergy or hypersensitivity to morphine
• Pregnancy <40 weeks (corrected)
• Pregnant women at 20 weeks or over gestation currently in labour.

Question 7

What is the route, onset, peak and duration of morphine?

Answer 7

• IM/SC: Onset 5-10min, Peak 25-40min, Duration 1-2hrs.
• IV: Onset 2-5min, Peak 10 min, Duration 1-2hrs.

Question 8

What is the preparation of morphine?

Answer 8

10mg (1ml) ampoule, diluted with 9ml NaCl to a total volume of 10ml (1mg:1ml).

Question 9

What is the correct dose of morphine for IM administration?

Answer 9

• For patients <1yo: 100mcg/kg diluted bolus (max bolus 10mg)
  
  • Repeat: 30min
  • Max dose: 2 doses
• For patients 1yo - <16yo: 100mc/kg diluted bolus (max bolus: 5mg)
  
  • Repeat: 5min
  • Max dose: 0.5mg/kg
• For patients 16yo - <65yo: 5-10mg undiluted bolus
  
  • Repeat: 15min
  • Max dose: 2 doses
• For patients 65+yo: 2.5-5mg undiluted bolus
  
  • Repeat: 15min
  • Max dose: 2 doses

Question 10

What is the correct dose of morphine for IV administration?

Answer 10

• For patients 1yo - <16yo: 100mcg/kg undiluted bolus (max bolus: 10mg)
  
  • Repeat: 5min
  • Max dose: 0.5mg/kg
• For patients 16yo - <65yo: 2.5 - 5mg diluted bolus
  
  • Repeat: 5min
  • Max dose: 0.5mg/kg
• For patients 65+yo: 1.25 - 2.5mg diluted bolus
  
  • Repeat: 5min
  • Max dose: 0.25mg/kg