MORPHINE

Mode of Action Analgesia at spinal level Sedation Miosis Euphoria Hallucinogenic effects Cardiac stimulant effects Dizziness Miosis Bradycardia Palpitations Hypotension Cardiac arrest Constipation Nausea Vomiting Urinary retention Severe respiratory arrest

Uses of morphine Symptomatic relief of acute and chronic pain. Preanasthetic medication Relieve dyspnea related to acute left ventricular failure and pulmonary edema Relieve pain of myocardial infarction.

Nursing implications Obtain baseline respiratory rate, depth and rhythm; size of pupil before administering the drug. Observe patient closely to be certain pain relief is achieved. Monitor carefully those at risk for respiratory depression for at least 24 hours after each dose. Assess vital signs at regular intervals. Encourage change in position, deep breathing and coughing at regularly scheduled intervals. Be alert for nausea and orthostatic hypotension in ambulatory patients. Monitor I&O ratio and pattern, report oliguria or urinary retention

Adverse effects Hypersensitivity Sweating Euphoria Insomnia Disorientation Visual disturbance Restlessness Decreased cough reflex Drowsiness