Morphine Sulfate

Question 1

Classification

Answer 1

Narcotic, opiate agonist

Question 2

Mechanism of Action

Answer 2

• Binds to opioid receptors
• Capable of inducing hypotension by depression of the vasomotor centers of the brain as well as release of histamine.
• Reduces stimulation of sympathetic nervous system caused by the pain & anxiety of angina.
• Reduction of sympathetic stimulation reduces heart rate, cardiac work, & myocardial O2 demand.

Question 3

Indications

Answer 3

• Moderate to severe pain
• Chest pain associated with ACS
• CHF
• Pulmonary Edema

Question 4

Contraindications

Answer 4

• Respiratory depression
• Shock
• Known sensitivity

Question 5

Adverse Effects

Answer 5

• Respiratory depression
• Hypotension
• Nausea, vomiting,
• Dizziness lightheadedness, sedation
• Worsening of bradycardia & heart block in some pts with acute inferior wall MI
• Seizures, cardiac arrest
• Anaphylactoid reactions

Question 6

Administration

Answer 6

• Pain (Adult): 2-10 mg IV/IO/IM/SubQ slowly over several minutes.
• Chest Pain associated with ACS, CHF or Pulmonary Edema (Adult): 2-10 mg IV/IO slowly over 1-5 minutes.

Question 7

Special Considerations

Answer 7

• Use with caution in hypotension, acute bronchial asthma, respiratory insufficiency, and head truama.
• Monitor vital signs and pulse oximetry closely
• Be prepared to support airway and ventilations
• Treat OD with naloxone.