Page 162 - 2023 SMOG Digital

MORPHINE Lactation Yes(Caution) Trade Name:
Class / Mechanism of Action
Opioid Analgesic
Binds to opioid receptors within the CNS increasing pain threshold and altering pain reception; inhibits
ascending pain pathways (blocking painful stimulus); produces CNS depression
Onset: IV variable but rapid, Duration variable, patient dependent.
Indications
Labeled Indications: Moderate to severe acute and chronic pain; pain of myocardial infarction;
preanesthetic medication
Contraindications
• Hypersensitivity to morphine sulphate or any component of the formulation
• Severe respiratory depression
• Acute or severe asthma (in an unmonitored setting or without resuscitative equipment)
• Paralytic ileus
Adverse Reactions / Precautions
• Always be prepared for use of paralytic and intubation (maintain positive control of airway).
• Head trauma: Use with extreme caution in head injury, or suspected increased ICP;
exaggerated increase in ICP may occur. Some formulations are specifically contraindicated.
• May cause Hypotension, Use with caution in hypovolemic patients.
• May worsen Bradycardia
• May cause life-threatening hypoventilation and Reparatory depression
• CNS depression: Impairs physical and mental abilities
Dose and Administration: ADULT PEDIATRIC Always Reference BROSELOW Tape
Chest Pain/AMI: Acute pain (moderate-to-severe):
IV/IO:
• 2-5mg q5-15min prn IM, SubQ: The use of IM/ SubQ injections is no
longer recommended especially for repeated
administration due to painful administration,
Acute pain (moderate-to-severe): variable absorption and lag time to peak effect.
IV: (Slow)
IM, SubQ: The use of IM/SubQ injections is no
longer recommended especially for repeated • 0.1-0.2 mg/kg q2-4hr prn not to exceed 10mg
administration due to painful administration, per dose
variable absorption and lag time to peak effect.
Continuous infusion:
IV/IO: (Slow) • 10-30mcg/kg/hour; titrate prn for pain
• 5mg (0.1mg/kg, range 2.5–10mg) q1-6hr prn

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