MORPHINE SULFATE

Question 1

CLASS

Answer 1

-NARCOTIC (OPIATE) ANALGESIC

CONTROLLED SUBSTANCE SCHEDULE II

Question 2

ACTIONS

Answer 2

• ANALGESIC
• REDUCES PRELOAD (INCREASES VENOUS CAPACITANCE) AND REDUCES AFTERLOAD (SYSTEMIC VASCULAR RESISTANCE) AND DECREASES MYOCARDIAL OXYGEN DEMAND BY REDUCING INTRAMYOCARDIAL WALL TENSION IN PULMONARY EDEMA. PRELOAD IS REDUCED MORE EFFECTIVELY THAN AFTERLOAD.

Question 3

INDICATIONS

Answer 3

• PAIN OF AMI, BURNS, KIDNEY STONES, ISOLATED EXTREMITY FRACTURES
• ACUTE PULMONARY EDEMA

Question 4

DOSAGES

Answer 4

• SEE HAWAII SO

- CAN BE GIVEN IM IF THIS ROUTE IS ORDERED

Question 5

STANDARD PREP

Answer 5

10 MG/CC TUBES

Question 6

PEDS DOSE

Answer 6

0.1 mg/kg/dose SLOW IV (dose not to exceed adult dose)

Question 7

CONTRAINDICATIONS

Answer 7

• ALLERGIES TO OPIATES
• HYPOVOLEMIA/ HYPOTENSION/ SHOCK
• HEAD INJURY WITH INCREASED ICP WHEN IT CAN MASK NEUROLOGICAL DETERIORATION (SAME AS A CVA PATIENT)
• DMINISHED LOC, COMA
• ABDOMINAL PAIN, UNKNONWN ETIOLOGY
• BRONCHIAL ASTHMA

Question 8

SIDE EFFECTS

Answer 8

• RESPIRATORY DEPRESSION
• HYPOTENSION (PRONOUNCED IN GERIATRICS, PEDS, DEBILITATED PTS.)
• DECREASED MENTAL STATUS
• BRADYCARDIA (RARE)
• BRONCHOSPASM (RARE)
• N/V
• EUPHORIA

Question 9

PRECAUTIONS

Answer 9

• HAVE RESUSCITATION EQUIPMENT AND NARCAN AVAILABLE
• MONITOR VS, EKG, MENTAL STATUS
• RESP. DEPRESSION OCCURS BEFORE PT. IS AWARE OF IT.
• POTENTIATES ACTION OF ETOH AND CNS DEPRESSION
• TITRATE TO PT’S. DECREASED SENSATION OF PAIN, NOT ABOLISHMENT OF PAIN.
• MAY WORSEN BRADYCARDIA OR HEART BLOCK IN INFERIOR MI (VAGOTONIC EFFECT)