Morphine CPG

Question 1

Morphine - Presentation

Answer 1

10 mg in 1 mL glass ampoule

Question 2

Morphine - Pharmacology

Answer 2

An opioid analgesic

Actions:

CNS effects

• Depression (leading to analgesia)
• Respiratory depression
• Depression of cough reflex
• Stimulation (changes of mood, euphoria or dysphoria, vomiting, pin-point pupils
• Dependence (addiction)

Cardiovascular effects:

• Vasodilatation
• Decreases conduction velocity through the AV node

Question 3

Morphine - Metabolism

Answer 3

By the liver; excreted by the kidneys

Question 4

Morphine - Primary emergency indications

Answer 4

1. Pain relief

2. Sedation to maintain intubation
3. Sedation to enable intubation
4. RSI

Question 5

Morphine - Contraindications

Answer 5

1. History of hypersensitivity
2. Renal impairment / failure
3. Late second stage of labour

Question 6

Morphine - Precautions

Answer 6

1. Elderly / frail Pt
2. Hypotension
3. Respiratory depression
4. Current asthma
5. Respiratory tract burns
6. Known addiction to opioids
7. Acute alcoholism
8. Pt on monoamine oxidase inhibitors

Question 7

Morphine - Route of administration

Answer 7

IV

IM

Subcutaneous

Question 8

Morphine - Side effects

Answer 8

CNS effects:

• Drowsiness
• Respiratory depression
• Euphoria
• Nausea, vomiting
• Addiction
• Pin-point pupils

Cardiovascular effects:

• Hypotension
• Bradycardia

Question 9

Morphine - Special notes

Answer 9

Morphine is a Schedule 8 drug under the Poisons Act and its use must be carefully controlled with accountability and responsibility.

Side effects of Morphine can be reversed with Naloxone

Occasional wheals are seen in the line of the vein being used for IV injection. This is not an allergy, only a histamine release.

IV effects:

Onset: 2 - 5min

Peak: 10min

Duration: 1 - 2hrs

IM effects:

Onset: 10 - 30min

Peak: 30 - 60min

Duration: 1 - 2hrs