Morphine Sulfate

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Morphine Sulfate
2010-02-21 18:07:34

Paramedic Pharmacology
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  1. Trade Name
    Astramorph/PF and others
  2. Class
    Opiod analgesic (shedule II narcotic).
  3. Mechanism of action
    Alleviates pain through CNS action, supresses fear and anxiety cneters in brain; depresses brain stem repiratory centers, increases peripheral venous capacitance and decreases venous return, decreases preload and afterload, which decreases myocardial oxygen demand.
  4. Indications
    Severe CHF, pulmonary edema, chest pain associated with acute MI, analgesia for moderate to severe acute and chronic pain ( use with caution).
  5. Contraindications
    Head injury, exacerbated COPD, depressed respiratory drive, hypotension, undiagnosed abdominal pain, decreased level of consciousness, suspected hypovolemia, pts. who have taken MAOIs within last 14 days.
  6. Adverse reactions
    Respiratory depression, hypotension, decreased leve of consciousness, nausea, vomiting, bradycardia, tachycardia, syncope, facial flushing, euphoria, bronchospasm, dry mouth.
  7. Drug interactions
    potentiates sedative effects of phenothiazines. CNS depressant may potentiate effects of morphine. MAOIs may cause paradoxical excitation.
  8. How supplied
    10 mg in 1 mL of solution, ampules, and Tubex syringes.
  9. Dosage and Administration
    • Adult: initial dose: 2-4 mg IV (over 1-5 minutes) every 5-30 minutes. Repeat dose: 2-8 mg at 5 to 15 minute intervals.
    • Pediatric: 0.1-0.2 mg/kg per dose via IV, IO, IM, or SC; maximunm of 5 mg.
  10. Duration of action
    • Onset: Immediate
    • Peak effect: 20 minutes
    • Duration: 2-7 hours
  11. Special considerations
    Pregnancy safety: category C. Morphine rapidly crosses the placenta. Safety in neonate not established. Use with caution in geriatric population and those with COPD, asthma. Vagotonic effect in pt. with acute inferior MI (bradycardia, heart block). Naloxone should be readily available as an antidote.