Morphine Sulfate (M.S. MS04)

Question 1

Morphine - Class

Answer 1

• Narcotic analgesic

* CNS Depressant

Question 2

Morphine - Actions

Answer 2

• CNS Depression - binds to opiate receptors in the brain
• Decreases pain perception and anxiety
• Relaxes respiratory effort
• Produces peripheral vasodilation and subsequent decreased blood return to the heart (preload)

Question 3

Morphine - Indications

Answer 3

• CP of suspected cardiac origin (for pain & anxiety relief) if Nitro ineffective
• Moderate to severe pain (burns or isolated extremity trauma)
• Abdominal pain (non-traumatic), suspected kidney stones
• Discomfort secondary to transcutaneous pacing in the awake pt

Question 4

Morphine - Dosage/Route

Answer 4

2 - 20 mg in 2 mg increments slow IVP; titrated to pain relief & respiratory response

Question 5

Morphine - Side Effects

Answer 5

• Respiratory depression &/or arrest
• Deceased LOC
• Transient hypotension
• N/V (stimulation of vomiting center)

Question 6

Morphine - Contraindications

Answer 6

• Know hypersensitivity to the drug
• Volume depletion
• Suspected ectopic pregnancy, abruptio placenta, or abdominal aortic aneurysm
• Unstable VS
• Head injury
• MAOI’s within 14 days

Question 7

Morphine - Special Information

Answer 7

• Naloxone will antagonize OD effects
• Monitor BP, pulse, and respiratory rates between increments
• Utilize caution for pts with COPD, asthma, compromised respirations, & the elderly
• Consider utilization of naloxone if the pt demonstrates respiratory arrest or hypotension post administration (naloxone may not reverse hypotension)
• Assess effectiveness of admin with reassessment of pain & respiratory status of pt
• Anticipate vomiting

Question 8

Morphine - Pediatric Note

Answer 8

• Refer to Pediatric Drug Guide

* 0.1 - 0.2 mg/kg slow IVP to a max of 5 mg (usual range)