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Morphine Sulphate

TYPE: Narcotic analgesic
PRESENTATION 1. Decreases pain perception and anxiety 2. Vasodilatation
USES 1. To relieve severe pain 2. Acute pulmonary oedema 3. RSI 4. Sedation of a previously intubated patient
ADVERSE EFFECTS 1. Nausea and vomiting 2. Drowsiness 3. Respiratory depression 4. Hypotension 5. Dependence 6. Pin point pupils 7. Bradycardia
CONTRA-INDICATIONS 1. Depressed level of consciousness(GCS 13 or less)* Pain relief only 2. Respiratory depression * Pain relief only. 3. Known hypersensitivity 4. BP < 70mmHg (pain relief) 5. BP < 90mmHg APO 6. Acute asthma attacks 7. Pain management in labour
PRECAUTIONS: 1. Elderly patients (may be sensitive) 2. Patients with COAD 3. Hypovolaemic patients (hypovolaemia should be corrected before Morphine administration) 4. Patients with systolic BP 70 – 90mmHg (see below) 5. Children under 1 year
Dose pain relief IV Adult: Up to 0.05 mg/kg lV, over 2 min May be repeated at 5 min ints, until pain is Mx PaedUp to 0.05 mg/kg IV over 2 min May be rpt at 5 min ints, until pain is relieved Use with caution under 1 yo Morphine admin can be used alternately w Ketamine.
Dose pain IM Pain relief only. Not for chest pain if cardiac ischaemia suspected No IV available No hypotension Patient contact estimated > than 20 minutes Dose: 0.1 mg/kg Repeat x 1 after 30 – 45 minutes as required
Dose Pain SBP 70-90 hypovolaemic pts: fluids,up to half 0.05 mg/kg dose, given slowly,rpt as req,, with great care, and with an appropriate time int between doses, titrated to response. no further doses if sBP drops 10or more with half dose, even if above 70
Dose APO 0.05 mg/kg lV, over 2 minutes May be repeated x 1 after 10 minutes, if required.
Dose w/ midaz for RSI Adult: 10 mg IV rapid push (dose adjusted for patient weight, age and BP). Paediatric: 0.05 mg/kg rapid push Repeat x 1 if required.
Dose to maintain tube 0.05 mg/kg lV, slow IV dose
Created by: mattypepper