Morphine Drug Study

In making a Drug Study, the following elements must be present: Generic Name and the Brand name (not all brands, just the brand used by the patient), Action, Indication, Pregnancy Category, Drug Classification, and Contraindication, Adverse Effect, Drug interaction and Nursing Consideration/Intervention…. Most clinical instructors preferred this to be in a long bond paper in printed or handwritten with paper in landscape.

Morphine sulfate

Pregnancy Category C, C-II controlled substance

Drug class: Narcotic agonist analgesic

Therapeutic actions

Principal opium alkaloid; acts as agonist at specific opioid receptors in the CNS to produce analgesia, euphoria, sedation; the receptors mediating these effects are thought to be the same as those mediating the effects of endogenous opioids (enkephalins, endorphins).

Indications

· Relief of moderate to severe acute and chronic pain

· Preoperative medication to sedate and allay apprehension, facilitate induction of anesthesia, and reduce anesthetic dosage

· Analgesic adjunct during anesthesia

· Component of most preparations that are referred to as Brompton's cocktail or mixture, an oral alcoholic solution that is used for chronic severe pain, especially in terminal cancer patients

· Intraspinal use with microinfusion devices for the relief of intractable pain

· Unlabeled use: dyspnea associated with acute left ventricular failure and pulmonary edema

Contraindications

· Contraindicated with hypersensitivity to narcotics; diarrhea caused by poisoning until toxins are eliminated; during labor or delivery of a premature infant (may cross immature blood–brain barrier more readily); after biliary tract surgery or following surgical anastomosis; pregnancy; labor (respiratory depression in neonate; may prolong labor).

Adverse effects

Light-headedness, dizziness, sedation, euphoria, dysphoria, delirium, insomnia, agitation, anxiety, fear, hallucinations, disorientation, drowsiness, lethargy, impaired mental and physical performance, coma, mood changes, weakness, headache, tremor, convulsions, miosis, visual disturbances, suppression of cough reflex

Facial flushing, peripheral circulatory collapse, tachycardia, bradycardia, arrhythmia, palpitations, chest wall rigidity, hypertension, hypotension, orthostatic hypotension, syncope

Pruritus, urticaria, laryngospasm, bronchospasm, edema

Nausea, vomiting, dry mouth, anorexia, constipation, biliary tract spasm; increased colonic motility in patients with chronic ulcerative colitis

Drug Interactions:

· Increased likelihood of respiratory depression, hypotension, profound sedation or coma in patients receiving barbiturate general anesthetics

Nursing considerations

· Caution patient not to chew or crush controlled-release preparations.

· Dilute and administer slowly IV to minimize likelihood of adverse effects.

· Direct patient to lie down during IV administration.

· Provide narcotic antagonist, facilities for assisted or controlled respiration on standby during IV administration.

· Use caution when injecting SC or IM into chilled areas or in patients with hypotension or in shock; impaired perfusion may delay absorption; with repeated doses, an excessive amount may be absorbed when circulation is restored.

· Reassure patient about addiction liability; most patients who receive opiates for medical reasons do not develop dependence syndromes.