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26 Cards in this Set

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Morphine Other Names
Duramorph,
Roxanol,
MS-Contin
Morphine Class-Pharmacologic
Opioid
Morphine Class-Therapeutic
Narcotic analgesic
Morphine Mechanism of Action
Powerful CNS depressant. It also increases the capacity of the venous circulation, pooling blood and decreasing blood return to the heart, thereby reducing myocardial oxygen demand. Also decreases systemic vascular resistance.
Morphine Therapeutic Benefit
Relieves pain caused by cardiac ischemia or trauma
Morphine Indications for Use
Chest pain with ACS unresponsive to nitrates.

Pain management analgesia in burns, & trauma
Morphine Contraindications
Hypersensitivity

Hypotension

Respiratory depression

Head injury

Undiagnosed abdominal pain.

Patients taking depressant drugs.
Morphine Precautions
Administer slowly!

May cause respiratory depression (SpO2 <95%)

May cause hypotension in volume-depleted patients. (SBP <100 for adults, SBP<70 + 2(age in years/ for children <14 yo).

Use with caution in right ventricular infraction.

Reduce dose in patients >65 yo
Morphine Route & Dosage
Adult: 2-5 mg IV (0.05mg/kg), may repeat dose every 5 minutes until maximum of 0.2 mg/kg. 5-20 mg SC or IM every 4 hours prn.
Morphine Side Effects
CNS: Confusion, sedation, headache, seizures, euphoria, somnolence, light headness, syncope

CV: Hypotension, bradycardia, tachycardia, hypertension

RESP: Respiratory depression, apnea

GI: Nausea, vomiting, constipation

SKIN: Rashes, pruritus, flushing

EYES: Dry eyes, blurred vision
Morphine Drug Interactions
Effects may be reversed with narcan (0.4-2mg IV).

Additive CNS depression may occur when morphine is used with alcohol, antihistamines, sedative/hypnotics, antidepressants, barbiturates.
Morphine Protocols
PA ALS
6003-1-2,
6071- 1-4
Morphine
Onset
Peak
Duration
Onset: 5 min IV, 10-30 IM or SC

Peak: 20 min IV, 30-60 min IM or 50-90 min SC

Duration: 4-5 hr IV, SC or IM
Narcan Drug Name
Naloxone
Narcan Class-Pharmacologic:
Narcotic antagonist
Class-Therapeutic: Narcan
Narcotic antagonist
Narcan Mechanism of Action
Competes with narcotic drugs opiate receptors in the CNS. This competitive action displaces narcotic analgesics from their receptor sites, blocking their effects, which include CNS depression and respiratory depression.
Narcan Therapeutic Benefit
Reverses the effects of narcotics
Narcan Indications for Use
Treat symptomatic narcotic overdose. Also can be used as a diagnostic tool in a coma of unknown origin.
Narcan Contraindications
Hypersensitivity
Narcan Precautions
Use in cautions in administering to patients with supraventricular arrhythmias, head injury, increased cranial pressure. Narcan may also cause seizures so use caution in administering it to patients with convulsive disorders.

Larger doses of narcan can precipitate opiate withdrawl syndrome with the potential for violent or combative patient behavior.
Narcan Route & Dosage
Adults: 0.4 mg IV or IO or 2 mg IM or Intranasal. May repeat every 2-3 minutes in 0.4 mg increments to a total of 2 mg.
Narcan Side Effects
CNS: Tremors, seizures
RESP: Pulmonary edema
CV: Ventricular tachycardia, ventricular fibrillation, hypotension or hypertension.
GI: Nausea & vomiting
Skin: Diaphoresis
Narcan Drug Interactions
Propoxyphene and dextromethorphan require higher doses of narcan.
Narcan Protocols
PA ALS 7002A
Narcan
Onset, peak, duration
Onset: 1-2 min IV, 2-5 min IM or SC

Peak: 5-15 min IV, SC or IM

Duration: Variable all routes