Morphine Sulfate

Question 0

Drug Classification

Answer 0

Narcotic analgesic

Question 1

What is its 2nd Action?

Answer 1

Depresses CNS by interacting with opiate receptors in the brain

Question 2

What is its 1st action?

Answer 2

Decreases pain perception & produces euphoria

Question 3

What is its 3rd action?

Answer 3

⬇️ ❤️ O2 demand by:

• ⬇️ Preload by peripheral vasodilation causing venous pooling & ⬇️ venous return
• ⬇️ Afterload by peripheral vasodilation causing ⬇️ systemic vascular resistance

Question 4

1st Indication

Answer 4

Moderate to Severe Pain

esp. Burns and fractures

Question 5

2nd Indication

Answer 5

CP of myocardial origin

Question 6

3rd Indication

Answer 6

Pulmonary Edema

Not in LA

Question 7

Contraindications?

Answer 7

1. Hypotension
2. ⬆️ ICP - Head injury
3. Pt’s at risk for Respiratory Depression (rate

Question 8

Adverse Effects

Answer 8

CARDIO-tachy, brady, hypotension 
RESP- bronchospasm, depression, apnea
NEURO- sedation-aloc, dizziness, agitation, tremors/seizures, hallucinations, blurred vision
G/I- n/v
OTHER- itching, flushed skin

Question 9

Administration

Answer 9

Pain Control

2-10mg slow (2mg/min) IVP
Titrate to pain relief
May repeat IVP dose prn to max. 20mg

5-10mg IM single dose, no repeat

Question 10

PEDS

Answer 10

0.1mg/kg slow (1mg/min)
Titrate to pain relief

0.1 mg/kg IM single dose, no repeat

Question 11

Onset

Answer 11

2-5 min. IVP

5-30 min. IM

Question 12

Duration

Answer 12

3-4 hours

Question 13

What other drug should be available and why?

Answer 13

Naloxone

Reverse resp. depression caused by morphine

Question 14

Why does morphine cause hypotension?

Answer 14

Histamine mediated hypotension

Volume depleted

Right Ventricular MI

Question 15

Use caution for these patients:

Answer 15

Sudden onset headache
Active Labor
Elderly
ETOH/Drugs

Question 16

How can morphine be mixed?

Answer 16

Mix 10mg (1mL) w/ 9ml of NS
To produce a concentration of
1mg / 1mL

Question 17

How is Morphine supplied?

Answer 17

4mg vial

10mg in 1 mL vial, pre-filled syringe or ampule

Question 18

What schedule is Morphine

Answer 18

Schedule II

Question 19

Reference #806

Isolated extremity injury/burn

Answer 19

Moderate to Severe pain
2-4mg slow IVP. Titrate to relief.
May repeat one time.

PEDS: 0.1mg/kg slow IVP
NO REPEAT
Max total dose 4mg

Question 20

Reference #806

Crush injury

Answer 20

2-12 mg slow IVP. Titrate to pain relief.
Max dose total 20mg

PEDS: 0.1mg/kg slow IVP
NO REPEAT
Max dose total 4mg