Home Drug Guide Morphine Sulfate

Drug Guide

Generic Name

Morphine Sulfate

Brand Names Duramorph Pf, Infumorph, Ms Contin, Oramorph Sr, Morphine Sulfate (autoinjector), Kadian, Avinza, Depodur, Astramorph Pf, Mitigo, Morphabond Er, Arymo Er

Classification

Therapeutic: Analgesic, Opioid

Pharmacological: Mu-opioid receptor agonist

FDA Approved Indications

  • Moderate to severe pain management

Mechanism of Action

Binds to mu-opioid receptors in the central nervous system, altering the perception of and response to pain.

Dosage and Administration

Adult: Dose varies based on severity; typically 10-30 mg every 4 hours as needed, titrated to response.

Pediatric: Dosing based on weight and severity; consult specific pediatric guidelines.

Geriatric: Start with lower doses due to increased sensitivity; titrate carefully.

Renal Impairment: Use cautiously; adjust doses as needed.

Hepatic Impairment: Use cautiously; start with lower doses; monitor closely.

Pharmacokinetics

Absorption: Well absorbed IM, subcutaneously, and orally.

Distribution: Widely distributed; crosses the blood-brain barrier.

Metabolism: Primarily hepatic via conjugation.

Excretion: Renal excretion of metabolites.

Half Life: 2-4 hours in typical adult dosing, variable with formulation.

Contraindications

  • Significant respiratory depression
  • Acute or severe bronchial asthma

Precautions

  • Use with caution in patients with head injury, dehydration, or CNS depression; addiction history; monitor respiratory and sedation levels closely.

Adverse Reactions - Common

  • Respiratory depression (Serious)
  • Sedation (Common)
  • Nausea (Common)
  • Vomiting (Common)

Adverse Reactions - Serious

  • Hypotension (Less common)
  • Circulatory depression (Less common)
  • Confusion (Common)
  • Addiction, abuse, and misuse (Serious)

Drug-Drug Interactions

  • CNS depressants (e.g., benzodiazepines, alcohol) increase risk of respiratory depression
  • MAO inhibitors can cause excitation, seizures, or severe hypotension

Drug-Food Interactions

  • Alcohol may potentiate CNS depression

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor pain relief, respiratory rate, level of consciousness, sedation, blood pressure.

Diagnoses:

  • Risk for respiratory depression
  • Impaired comfort

Implementation: Administer cautiously, observe for signs of overdose, titrate dose to pain relief.

Evaluation: Assess pain relief effectiveness and monitor for adverse effects.

Patient/Family Teaching

  • Do not operate heavy machinery or perform hazardous tasks while on medication.
  • Avoid alcohol and CNS depressants.
  • Report signs of respiratory depression, excessive sedation, or allergic reactions.

Special Considerations

Black Box Warnings:

  • Addiction, abuse, and misuse can lead to overdose and death.
  • Life-threatening respiratory depression.

Genetic Factors: Genetic variations may influence metabolism (e.g., CYP2D6 activity).

Lab Test Interference: May interfere with certain drug screening tests, causing false positives or negatives.

Overdose Management

Signs/Symptoms: Respiratory depression, sedation, pinpoint pupils, unconsciousness.

Treatment: Administer naloxone promptly; supportive measures include maintaining airway, ventilation, and cardiovascular support.

Storage and Handling

Storage: Store at room temperature away from light and moisture.

Stability: Stable when stored properly; check specific product labeling for expiry details.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.