Morphine & Nitro

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Author:
cjl410
ID:
168338
Filename:
Morphine & Nitro
Updated:
2012-09-16 19:16:53
Tags:
Phoenix College Paramedic 2012 2013 Drug Profiles Morphine Nitroglycerin
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Description:
PCC - Drug Profile - Morphine & Nitroglycerin
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  1. What is the generic name of Morphine? 
    Morphine Sulfate
  2. Brand name of morphine?
    Morphine
  3. Class of morphine?
    • Opiate Agonist
    • Narcotic
  4. Mechanism of Action of Morphine
    • Binds to opiate receptors in CNS
    •      Alters perception and response to pain
    •      
    •     CNS depression
    •           Respiratory depression
    •           Vasomotor center depression
    •                Vasodilation
    •      
    •      Releases histamine
    •           Vasoldilation
    •           Itching/hives
  5. Indications and field use of Morphine
    • Analgesia
    •      Chest pain of probable cardiac origin
    •      Major burns
    •      Isolated muscosceletal injury
    •      Kidney stones

         Why - Binds to opiate receptors in CNS altering perspective of pain

    CHF
  6. Dosage of Morphine?
    Via slow IV push or IM

    • Adult:
    • Chest pain or isolated muscoskeletal injury - 
    •      MS 2-4mg slow IV push q 5 minutes if BP >100, max 10mg

    • Major burns - 
    •      MS 2-4mg slow IV push q 5 minutes if BP >100, max 20mg
  7. Contraindications of Morphine?
    • Known hypersensitivity
    • Hypotension
    • Decreased LOC
  8. Drug Interactions with Morphine?
    • Potentiated by other CNS depressants
    • Overdose/side effects reversed by Narcan
  9. Side effects of Morphine?
    • True allergic reaction (Patch with Medical Control)
    • Itching/hives (due to histamine release, not allergy, patch with Medical Control)
    • Hypotension
    • CNS depression
    • Bradycardia
    • Nausea/Vomiting
    • Anxiety
  10. Onset of Action of Morphine?
    Seconds
  11. AZ Drug Box Supply of Morphine?
    2 x 10mg in 1cc sealed prefilled Tubex syringe or ampule
  12. Special note for Morphine?
    Schedule II controlled substance, requires documentation and DEA tracking
  13. What is the Generic name for Nitro?
    Nitroglycerin
  14. What is the brand name for Nitro?
    • Nitrostat
    • Tridil
  15. What is the class for Nitro?
    Nitrate
  16. What is the Mechanism of Action for Nitro?
    • Nitrates release nitric oxide which relaxes smooth muscle
    •      Dilation of vascular smooth muscle
    •           Reduces preload
    •           Reduces afterload
    •           Dilation of coronary arteries
  17. Indications and field use of Nitro?
    • Chest pain of probable cardiac origin - Why?
    •      Reduced preload and afterload decreasing myocardial workload
    •      Dilation of coronary arteries increases blood flow to myocardium

    • CHF - Why?
    •      Reduced preload reduces amount of blood sent to the lungs
    •      Reduced afterload allows left ventricle to move blood out of the lungs
  18. Dosage of Nitro?
    Dosage is via SL tablet or spray

    • Adult:
    • Chest pain
    •      - NTG 0.4mg SL tablet or spray q 5 minutes if BP >100, max 3 times

    • CHF with pulmonary edema
    •      - NTG 0.4mg SL tablet or spray q 5 minutes if BP >100, no max
  19. Contraindications of Nitro?
    • Right ventricle MI
    • Known hypersensitivity or allergy
    • Hypotension BP >100 systolic
    • Head injury / CVA
    • Erectile dysfunction drugs - Viagra, Cialis, Levitra
  20. Drug Interactions with Nitro?
    • Potentiated by anti-hypertensives
    •      Alcohol
    •      Beta-blockers
    •      Calcium-channel blockers
  21. Side effects of Nitro?
    • Headache
    • Bitter taste / Burning feeling in mouth
    • Hypotension - consider starting IV prior to NTG administration
    • Syncope - do not have patient walk after NTG admin
    • Tachycardia
  22. Onset of Action of Nitro?
    1-5 minutes
  23. AZ Drug box supply of Nitro?
    • Dark glass bottle with 25 0.4mg tablets
    • Red spray bottle with 200 metered 0.4 sprays
  24. Special Notes for Nitro?
    • NTG is heat, light and air sensitive, so keep in dark closed container
    • NTG infusion must be done with glass IV bottle

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