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Astramorph/PF and others
Opiod analgesic (shedule II narcotic).
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.
Severe CHF, pulmonary edema, chest pain associated with acute MI, analgesia for moderate to severe acute and chronic pain ( use with caution).
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.
Respiratory depression, hypotension, decreased leve of consciousness, nausea, vomiting, bradycardia, tachycardia, syncope, facial flushing, euphoria, bronchospasm, dry mouth.
potentiates sedative effects of phenothiazines. CNS depressant may potentiate effects of morphine. MAOIs may cause paradoxical excitation.
10 mg in 1 mL of solution, ampules, and Tubex syringes.
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.
Duration of action
- Onset: Immediate
- Peak effect: 20 minutes
- Duration: 2-7 hours
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.