Morphine Sulfate

(Duramorph, Astramorph)

Classification:    

 Narcotic Analgesic

CNS depressant

Action:                      

Alters pain perception in the CNS

Produces euphoria

Decreases peripheral vascular resistance

Decreases myocardial O2 demand by reducing preload and afterload 

Indications:

Moderate to severe pain

Chest pain of suspected acute myocardial infarct

Acute pulmonary edema (cardiogenic shock)

Contraindications: 

Altered level of consciousness

 Head Injury

 Abdominal pain of unknown origin

 Hypovolemia

Patients at risk for respiratory depression

Adverse Effects:

Cardiovascular

hypertension

hypotension

tachycardia

bradycardia

Respiratory

depression

arrest

Neurological

dizziness

tremors

seizures

hallucinations

Gastrointestinal

nausea/vomiting

Administration:      

1-10 mg IV @ 2mg/min. (titrate to relief of pain) May repeat to a maximum dose of 20mg.                                              

5-15 mg IM. May repeat to a maximum dose of 20mg.

Pediatric:                             

0.1-0.2mg/kg IV/IO @1-2 mg/min. (titrate to relief of pain) May repeat to a maximum dose of 10mg.

Onset:                   

Duration:               

Onset:      IV 2-5 minutes  IM 5-10 minutes

Duration:            3-5 hours

Precautions:            

Monitor patient for respiratory depression, hypotension and nausea.

Naloxone (Narcan) is the antidote for overdose, consider prior to intubation.

Naloxone will only reverse the respiratory effects of MS be prepared to treat for hypotension.