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- naturally occuring opium alkaloid
- produces profound analgesia
- causes euphoria produces sedation
- constricts the pupils
- relieves SOB in MI
- cardiac failure
Relieves chest pain associated with
relief of serious
acute and chronic pain
pre-operative medication smooth muscle relaxant
morphine causes peripheral vasodilation
- by decreasing SVR
- decreases MO2 demand
morphine causes profound
morphine adverse effects
- urinary retention
- ** BPH exacerbated physical/psychological dependence
- high doses long duration
- respiratory depression
- cardiac arrest
- increased ICP from CO2 retention
- secondary to respiratory depression
- seizures from increased ICP
- cross tolerance with other opioids
- may mask gallbladder disease
- do not give in suspected
- gall bladder disease or pancreatic disease
- biliary tract spasm sphincter of Oddi acute asthma
- upper airway obstruction
- GO obstruction
- decreases persitalisis
- severe hepatic or renal disease
- respirations <12/min
Nursing Considerations Morphine
- Monitor clients health condition
- educate pt on drug Tx
Nursing Considerations Initial Assessment Morphine
- liver function renal function
- Current Med usage
- ETOH safety
- BR up
Nursing Interventions Morphine
- Assess LOC following medication administration
- Monitor VS Pain Levels
- Respiratory rate and depth
- monitor injection sites
- IV sites
- Offer additional pain relief measures
- hot packs
- ice packs
- Narcon available if resp fall to 10 or less
- may need to repeat doses
Nursing interventions morphine education
- Reassure risk of addition is minimal
- provide thorough patient education
- drug name
- prescribed dose
S/S of adverse effects when to call physician
- Monitor client response to morphine
- pain levels
- pain relief
- cough suppressant
- sedation decreased
- GI motility
- Monitor for adverse effects
- evaluate teaching effectiveness
- monitor compliance with pain management
Naturally occuring opium alkaloid
Codeine is a Schedule ____ drug
Codeine is an
Analgesic/Antitussive(weaker than morphine)
What is mode of administration?
Effective PO, subq, IM
Codeine has a strong _________ effects antitussive
less likely to cause abuse & dependency
codiene is usually given with
acetaminophen for additive effects but causes nausea & vomiting
Demerol pharmacologic action
is similar to MS04
Demerol - 80-100 mgm =
10 mg of morphine
Is Demerol natural or synthetic?
What is the generic name for Demerol?
What is the route for Demerol for children?
What is the dosage of Demerol for children?
50-150 mg q3-4h PRN, max: 100 mg q4h
What is the route for Demerol for adults?
What is the dosage of Demerol for adults?
1-1.5 mg/kg q3-4hr PRN
Demerol produces what kind of sedation?
Demerol has a _______ duration of action than morphine.
Demerol requires more or less adm?
Demerol has _____ antitussive effect
demerol causes smooth muscle
treatment of severe pain
what is the preferred analgesic for clients with renal or biliary colic?
what is used as a short term pain management in healthy clients?
Demerol is contraindicated in
- CA pain management
- requires increased doses
Demerol is not recommended for pain control longer than
Demerol is considered ______ line agent
What does the active metabolite of Demerol cause?
tremors and seizures
Is Demerol reversed by Narcan?
Why is Demerol NOT recommended for PCA use?
half life too short frequent dosing required q3-4 hrs
How do opioid antagoinist work?
- competes with opioid receptors sites in the brain
- prevents opioid binding
- displaces opioids already occupying receptor sites
- neutralizes opiods
what is dose of Narcan?
- 0.4 - 2.0 mg
- repeat q 2-3 minutes due to short half-life
Reverses or blocks analgesia
- reverses CNS depression
- reverses resp depression
Nursing interventions of opioids antagonists
- administer small doses often
- repeated until client exhibits reversal of opiate effects
- IV dose last 1 hr
- maintain airway resuscitation
- equipment immediately available
Routes for opioids antagonists
subq, IV, IM
Pharmacokinetics of opioid antagonists
- Hepatic metabolism renally excreted
- hepatic metabolism onset of action - IV 1-2 minutes
- duration of action - IV, 1 hr IM, up to 4 hrs
Adverse effects of opioid antagonists
- no common
- but serious include tachycardia