Morphine Sulfate

Trade Names: Astromorph, PF

Class: Opioid Analgesic
Pharmacology:

Onset: IV Immediate IM 15 min
Duration: 2-7 hr

Natural opium alkaloid with analgesia as primary effect

Secondary effects: decreases preload and after-load, decreases myocardial oxygen demand

Indications:

Chest pain associated with ACS
Acute cardiogenic pulmonary edema w/ or w/out pain
Moderate to severe acute chronic pain
Kidney stones

Contraindications:

Hypersensitivity to narcotics
Hypovolemia
Hypotension
Head injury
Undiagnosed abdominal pain (check local protocols)
Increased ICP
Severe respiratory depression
Patients who have taken MAO inhibitors with 14 days
Use with caution in RV infarction

Cautions:

CNS depressants may potentiate effects
Phenothiazines may potentiate analgesia
MAO inhibitors may cause paradoxical excitation
Narcan must be readily available

Dosage:
  • Adult: 2-10 mg IV; may give additional doses of 2-8 mg IV @ 5-15
  • Pediatric: 0.1-0.2 mg/kg IV (Max Dose: 15 mg)
Side Effects:

Hypotension in volume depleted patients
Tachycardia
Bradycardia
Palpitations
Syncope
Facial flushing, diaphoresis, pruritus
Respiratory depression
Euphoria
Bronchospasm
Dry mouth
Allergic reaction
AMS

Special Considerations:

Pregnancy Safety: Category B
Use w/ caution in elderly, asthma and those susceptible to CNS depression
Should be used w/ caution in chronic pain
Should be given with antiemetic