Morphine & Nitro
Card Set Information
Morphine & Nitro
Phoenix College Paramedic 2012 2013 Drug Profiles Morphine Nitroglycerin
PCC - Drug Profile - Morphine & Nitroglycerin
What is the generic name of Morphine?
Brand name of morphine?
Class of morphine?
Mechanism of Action of Morphine
Binds to opiate receptors in CNS
Alters perception and response to pain
Vasomotor center depression
Indications and field use of Morphine
Chest pain of probable cardiac origin
Isolated muscosceletal injury
Why - Binds to opiate receptors in CNS altering perspective of pain
Dosage of Morphine?
Via slow IV push or IM
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
Contraindications of Morphine?
Drug Interactions with Morphine?
Potentiated by other CNS depressants
Overdose/side effects reversed by Narcan
Side effects of Morphine?
True allergic reaction (Patch with Medical Control)
Itching/hives (due to histamine release, not allergy, patch with Medical Control)
Onset of Action of Morphine?
AZ Drug Box Supply of Morphine?
2 x 10mg in 1cc sealed prefilled Tubex syringe or ampule
Special note for Morphine?
Schedule II controlled substance, requires documentation and DEA tracking
What is the Generic name for Nitro?
What is the brand name for Nitro?
What is the class for Nitro?
What is the Mechanism of Action for Nitro?
Nitrates release nitric oxide which relaxes smooth muscle
Dilation of vascular smooth muscle
Dilation of coronary arteries
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
Dosage of Nitro?
Dosage is via SL tablet or spray
- 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
Contraindications of Nitro?
Right ventricle MI
Known hypersensitivity or allergy
Hypotension BP >100 systolic
Head injury / CVA
Erectile dysfunction drugs - Viagra, Cialis, Levitra
Drug Interactions with Nitro?
Potentiated by anti-hypertensives
Side effects of Nitro?
Bitter taste / Burning feeling in mouth
Hypotension - consider starting IV prior to NTG administration
Syncope - do not have patient walk after NTG admin
Onset of Action of Nitro?
AZ Drug box supply of Nitro?
Dark glass bottle with 25 0.4mg tablets
Red spray bottle with 200 metered 0.4 sprays
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