Morphine

Question 1

Morphine - Type

Answer 1

Narcotic analgesic

Question 2

Morphine - Presentation

Answer 2

10mg in 1ml

Question 3

Morphine - Actions (2)

Answer 3

1. Decreases pain perception and anxiety
2. Vasodilation

IV onset 2-5 min, duration 1-2 hrs

IM onset 5+ min, duration 2-3 hrs

Question 4

Morphine - Uses (3)

Answer 4

1. To relieve severe pain
2. Acute pulmonary oedema
3. Chest pain

Question 5

Morphine - Adverse effects (6)

Answer 5

1. Nausea and vomiting
2. Altered level of consciousness
3. Respiratory depression
4. Hypotension
5. Bradycardia
6. Dependence

Question 6

Morphine - Contraindications (4)

Answer 6

1. Respiratory depression (analgesic only)
2. BP < 70mmHg (analgesic only)
3. BP <90mmHg (APO)
4. Acute asthma attacks

Question 7

Morphine - Precautions (8)

Answer 7

1. Depressed level of consciousness (GCS under 14) (analgesic only)
2. Known hypersensitivity
3. Elderly pts (may be sensitive)
4. Pts with CAL (chronic airway limitation)
5. Hypovolaemic pts (correct before administration)
6. Pts with systolic BP 70-90mmHg
7. Children <1 year
8. Pain management in labour

Question 8

Morphine - Doses

Answer 8

Analgesia

• Adult and Paediatric
• up to 0.05mg/kg IV, rep @ 5/60 as req, no max.
• sBP 70-90mmHg
• Up to half 0.05mg/kg dose
• IV only
• no further doses if sBP drops 10mmHg or more even if it remains above 70mmHg.
• 0.1mg/kg IM, repeat once after 30-45/60 if req
• not for chest pain is cardiac ischaemia suspected
• contact estimated >20 mins

Pulmonary oedema

• Adult only
• 1-2mg IV
• repeat once, after 20 mins if req

Question 9

Morphine - Special notes

Answer 9

Side effects may be reverse by use of naloxone, although preferable to avoid this if absolutely possible Elderly pts may be especially sensitive to morphine, and advanced age is often a better guide to dosing than weight