MORPHINE 1. Name & class of drug – generic and trade name. GENERIC NAME: Morphine sulfate BRAND NAME: Astramorph PF, Avinza, Duramorph, Epimorph, Kadian, MSIR, MS Contin, Oramorph SR, Roxanol 100, Roxanol, Roxanol-T, RMS, Statex CLASSIFICATION: CNS agent, analgesic, narcotic (opiate) agonist 2. Dose range and routes for adult & geriatric client. PREPARATIONS: PO, IV, IM, SC, PR DOSING: Adult (PO) 10-30mg q4h prn, or 15-30 mg sustained release q8 – 12 h. (IV) 2.5 – 15 mg q4h, or 0.8 – 10 mg continuous infusion, or 5 – 10 mg given epidurally q24h. (IM/SC) 5 – 20 mg q4h (PR) 10 – 20 mg q4h prn 3. Purpose prescribed. Underline reason your client is prescribed drug. THERAPEUTIC EFFECTS: Controls severe pain; also used as an adjunct to anesthesia. USES: Symptomatic relief of severe, acute and chronic pain after non-narcotic analgesics have failed and as preanesthetic medication; also used to relieve dyspnea of acute left ventricular failure and pulmonary edema and pain of MI. 4. Major side effects & drug interactions. DRUG INTERACTIONS: CNS depressants, sedatives, barbiturates, alcohol, benzodiazepines and tricyclic antidepressants potentiate CNS depressant effects. MAO inhibitors may precipitate hypertensive crisis. Phenothiazines may antagonize analgesia. Herbal – Kava kava, valerian, St. John’s Wort may increase sedation. SIDE EFFECTS: depressed respiration, drowsiness, dizziness, blurred vision.
5. Nursing Implications & teaching. • • • • •
Avoid alcohol and other CNS depressants while receiving morphine. Do not use OTC drug unless approved by physician Do not smoke or ambulate without assistance after receiving drug. Bedside rails are advised Use caution or avoid tasks requiring alertness (eg. Driving a car) until response to drug is known since drug may cause drowsiness, dizziness, or blurred vision Do not breast feed while taking this drug.