Class
Description
Onset and Duration
Indications
Contraindications
Adverse Reactions
Drug Interactions
How Supplied
Dosage and Administration
Special Considerations
Opioid analgesic
Morphine sulfate is a natural opium alkaloid that increases peripheral venous capacitance and decreases venous return ("chemical phlebotomy"). It promotes analgesia, euphoria, and respiratory and physical depression. Secondary pharmacological effects of morphine include depressed responsiveness of alpha-adrenergic receptors (producing peripheral vasodilation) and baroreceptor inhibition. In addition, because morphine decreases both preload and afterload, it may decrease myocardial oxygen demand. The properties of this medication make it extremely useful in emergency care. Morphine sulfate is a schedule II drug.
Chest pain associated with myocardial infarction
Moderate to severe acute and chronic pain
Should be used with caution in chronic pain syndromes
Pulmonary edema, with or with out associated pain
Hvpersensitivity to narcotics
Diarrhea caused bv poisoning
Hypovolemia
Hypotension
Head injurv or undiagnosed abdominal pain
Patients who have taken MAOIs within 14 days
Hypotension
Tachycardia or bradycardia
Palpitations
Syncope
Facial flushing
Respiratory depression
Euphoria
Bronchospasm
Dry mouth
Allergic reaction
CNS depressants may potentiate effects of morphine (respiratory depression, hypotension, sedation).
Chlorpromazine may potentiate analgesia. MAOls may cause paradoxical excitation.
Morphine is supplied in tablets, suppositories, and solution. In emergency care, morphine sulfate is usually administered IV. Parenteral preparations are available in many strengths. A common preparation is 10 mg in 1 ml of solution, ampules, and Tubex syringes.
Pregnancv safetv: Category C.
Narcotics rapidly cross the placenta. Safety in neonates has not been established. Use with caution in older adults, those with asthma, and those susceptible to CNS depression. May worsen bradycardia or heart block in inferior myocardial infarction (vagotonic effect). Naloxone should be readily available.