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Morphine Sulfate
Trade Name
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Morphine Sulfate
Class
Opioid analgesic, Schedule II
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Morphine Sulfate
Mechanism of Action
- Alleviates pain through CNS actions
- Suppresses fear and anxiety centers in brain
- Depresses brain stem respiratory centers
- Increases peripheral venous capacitance and decreases venous return
- Decreases preload and afterload, decreasing myocardial oxygen demand
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Morphine Sulfate
Indications
- Analgesia for moderate to severe acute and chronic pain (use with caution)
- Adjunct prior to cardioversion or pacing
- Severe CHF (in RI, not in MA)
- Pulmonary edema (in RI, not in MA)
- Chest pain associated with acute MI (in RI, not in MA)
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Morphine Sulfate
Contraindications
- Head injury
- Exacerbated COPD
- Depressed respiratory drive
- Hypotension
- Undiagnosed abdominal pain
- Decreased level of consciousness
- Suspected hypovolemia
- Patients who have taken MAOIs within past 14 days
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Morphine Sulfate
Adverse Reactions
- Respiratory depression
- Hypotension
- Decreased level of consciousness
- Nausea
- Vomiting
- Bradycardia
- Tachycardia
- Syncope
- Facial flushing
- Euphoria
- Bronchospasm
- Dry mouth
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Morphine Sulfate
Drug Interactions
- Potentiates sedative effects of phenothiaxines
- CNS depressant may potentiate effects of morphine
- MAOIs may cause paradoxical excitation
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Morphine Sulfate
How Supplied
10 mg in 1 ml of solution, ampules and Tubex syringes
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Morphine Sulfate
Dosage and Administration
Adult
- 1-3 mg IV, IM, SC every 5 minutes titrated to maximum of 10 mg.
- 0.1mg/kg to a maximum of 10mg IV/IM/SC
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Morphine Sulfate
Dosage and Administration
Pediatric
0.1 -0.2 mg/kg dose IV, IO, IM, SC q 5 minutes titrated to max of 5 mg
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Morphine Sulfate
Duration of Action
- Onset: Immediate
- Peak effect: 20 minutes
- Duration: 2 -7 hours
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Morphine Sulfate
Special Considerations
- 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
- Naloxone should be readily available as antidote
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