Morphine sulfate

dr.joandr.joan عضو ماسي
تم تعديل 2009/07/02 في أدوية الطوارئ Emergency drugs
- Morphine sulfate :
Trade names: Roxanol
Class: Narcotic analgesic, morphine type.
Pregnancy: (Category C / D if used for prolonged periods or in high doses at term)
  • Narcotic analgesics attach to specific receptor in the CNS resulting in analgesia- action
  • Action exactly is unknown but may be by decreasing cell membrane permeability to sodium transmission of pain impulses.
  • Intrathecally, epidurally, orally or I.V. infusion for acute or chronic pain.
  • Preoperative medication.
  • To facilitate induction of anesthesia or to decrease the dose of anesthesia.
§ acute pain, by intramuscular injection, 10 mg every 4 hours if necessary (15 mg for heavier well-muscled patients); CHILD up to 1 month 150 micrograms/kg, 1–12 months 200 micrograms/kg, 1–5 years 2.5–5 mg, 6–12 years 5–10 mg.By slow intravenous injection, quarter to half corresponding intramuscular dose
§ Premedication, by subcutaneous or intramuscular injection, up to 10 mg 60–90 minutes before operation; CHILD, by intramuscular injection, 150 micrograms/kg
§ Myocardial infarction, by slow intravenous injection (2 mg/minute), 10 mg followed by a further 5–10 mg if necessary; elderly or frail patients, reduce dose by half
§ Acute pulmonary edema, by slow intravenous injection (2 mg/minute) 5–10 mg
· It is given epidural or intrathecal, if infection is present at injection site.
· In patients on anticoagulant therapy .
· Bleeding disorders.
· If patients have received parenteral corticosteroids within the past 2 weeks.
Side effects:
Respiratory depression , apnea, dizziness, euphoria headache, mental clouding, insomnia nausea, vomiting, constipation, dry mouth, skin rashes, laryngospasm, urinary retention, and decreased libido.
Nursing considerations:
  • Use supportive nursing measures as relaxation techniques to relieve pain before using narcotics.
  • Explore the source of pain, use non-narcotic analgesia if possible.
  • Administer the medication when needed, prolonging the medication administration will decrease the effect of the medication.
  • Monitor vital signs & mental status.
  • Monitor Respiratory rate (drug may lead to respiratory depression).
  • Monitor blood pressure ( hypotension may occur)
  • Monitor pulse rare (if 60\m withhold the drug).
  • Watch for constricted pupils. Document it and notify the physician.
  • Monitor bowel function, since drug may cause constipation .
  • Encourage client to empty bladder every 3-4 hrs (since drug may cause urinary retention).
  • If client is bed ridden, use side rails.
  • Inform the client\family that the drug may become habit forming and leading to addiction.
  • Document any history of asthma or other contraindications.
  • Have emergency equipment and narcotic antagonist available .