Morphine Sulfate : Action, Uses, Contraindications, Side effects

 Morphine Sulfate 

Classification 

Analgesic, opioid agonist 

High alert 

Action. Interacts at a specific receptor-binding site. Agonist activity at the receptors site can result in analgesia, euphoria, depression, hallucinations, miosis, and sedation. Alters pain at the spinal cord and higher levels in the central nervous system (CNS) ( schedule ll on controlled substance Act). 

Uses

• Relieves severe pain
• Decreases anxiety, therefore decreases myocardial oxygen demands with pain from a myocardial infarction. 

Contraindications 

• Hypersensitivity 

Precautions 

• Seizures, asthma, and severe respiratory depression. 
• Intracranial pressure and suspected head injuries; may mask the development of increased intracranial pressure 
• Hepatic and renal dysfunction; biliary tract surgery 

Side effects 

• Respiratory depression, cough suppression 
• Urinary retention, confusion 
• Constipation, nausea and vomiting 
• Orthostatic hypotension 
• Tolerance and physical dependency with long-term use
• Toxicity: coma, respiratory depression, and pinpoint pupils 

Nursing Implications 

• Perform strict documentation and inventory assessment of narcotic. 
• Assess pain and vital signs ( especially respiration ) before and after the dose, do not administer if respirations are less than 12 breaths per minute. 
• Infants and older adults are very sensitive to depression of respirations. 
• Naloxone (nacron) reverse the effect of morphine
• Medication of choice for patient-controlled analgesia. 
• Cancer patients should receive opioids on a fixed schedule; tolerance may occur, requiring dosage escalation.