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Morphine Sulphate
Question | Answer |
---|---|
TYPE: | Narcotic analgesic |
PRESENTATION | 1. Decreases pain perception and anxiety 2. Vasodilatation |
USES | 1. To relieve severe pain 2. Acute pulmonary oedema 3. RSI 4. Sedation of a previously intubated patient |
ADVERSE EFFECTS | 1. Nausea and vomiting 2. Drowsiness 3. Respiratory depression 4. Hypotension 5. Dependence 6. Pin point pupils 7. Bradycardia |
CONTRA-INDICATIONS | 1. Depressed level of consciousness(GCS 13 or less)* Pain relief only 2. Respiratory depression * Pain relief only. 3. Known hypersensitivity 4. BP < 70mmHg (pain relief) 5. BP < 90mmHg APO 6. Acute asthma attacks 7. Pain management in labour |
PRECAUTIONS: | 1. Elderly patients (may be sensitive) 2. Patients with COAD 3. Hypovolaemic patients (hypovolaemia should be corrected before Morphine administration) 4. Patients with systolic BP 70 – 90mmHg (see below) 5. Children under 1 year |
Dose pain relief IV | Adult: Up to 0.05 mg/kg lV, over 2 min May be repeated at 5 min ints, until pain is Mx PaedUp to 0.05 mg/kg IV over 2 min May be rpt at 5 min ints, until pain is relieved Use with caution under 1 yo Morphine admin can be used alternately w Ketamine. |
Dose pain IM | Pain relief only. Not for chest pain if cardiac ischaemia suspected No IV available No hypotension Patient contact estimated > than 20 minutes Dose: 0.1 mg/kg Repeat x 1 after 30 – 45 minutes as required |
Dose Pain SBP 70-90 | hypovolaemic pts: fluids,up to half 0.05 mg/kg dose, given slowly,rpt as req,, with great care, and with an appropriate time int between doses, titrated to response. no further doses if sBP drops 10or more with half dose, even if above 70 |
Dose APO | 0.05 mg/kg lV, over 2 minutes May be repeated x 1 after 10 minutes, if required. |
Dose w/ midaz for RSI | Adult: 10 mg IV rapid push (dose adjusted for patient weight, age and BP). Paediatric: 0.05 mg/kg rapid push Repeat x 1 if required. |
Dose to maintain tube | 0.05 mg/kg lV, slow IV dose |