Morphine Sulfate

Names

Roxanol, MS Contin

Classification

Opioid analgesic, schedule II drug

Mechanism

Binds to opioid receptors, producing analgesia and euphoria. Reduces CNS awareness of pain and slows down pain processing

Indications

Ischemic pain associated with AMI, analgesia for moderate to severe pain.

Contraindications

Hypersensitivity, head or spine injury, increased ICP, decreased respiratory function, undiagnosed ab pain, hypotension under 90 SBP. Cut dosage in half for concomitant use of cns depressants/alcohol.

Side effects

Confusion, sedation, respiratory depression, apnea, bronchospasm, hypotension, syncope, bradycardia, tachycardia, nausea, dry mouth, vomiting, bronchospasm, opioid-induced hyperalgesia (OIH)

Interactions

Use of Alcohol/CNS depressants potentiate respiratory depression. MAOI use < 14 days increase respiratory depression.

Adult dose

IV/IO/IM 2-10mg, 1-5 minutes IVP, repeat every 5 minutes (max total dose 15mg). Titrate dose by 2mg increments

Pediatric dose

V/IO/IM 0.1mg/kg (max single dose 4mg), 1-5 minutes IVP, repeat every 5 minutes (max total dose: 15mg). Titrate dose by 2mg increments

Onset/duration

ONSET: 5 - 15 minutes PEAK: 30 minutes DURATION: 3 - 5 hours

Consideration

Pregnancy Caution ( C ). Chest rigidity possible with rapid IVP. Ask about prior opioid administration, which can guide dose. Typically drops SBP 20 points