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Morphine PDF
Morphine PDF
1 REMS High Alert Half-life: Premature neonates: 10– 20 hr; Neonates: 7.6 hr; Infants 1– 3 mo: 6.2
hr; Children 6 mo– 2.5 yr: 2.9 hr; Children 3– 6 yr: 1– 2 hr; Children 6– 19 yr with
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morphine (mor-feen) sickle cell disease: 1.3 hr; Adults: 2– 4 hr.
Astramorph PF, AVINza, Doloral, Duramorph PF, Embeda, Epimorph, TIME/ACTION PROFILE (analgesia)
Infumorph, Kadian, M-Eslon, Morphine H.P, M.O.S, M.O.S.-S.R, MS ROUTE ONSET PEAK DURATION
Contin, Statex
PO unknown 60 min 4–5 hr
Classification PO-ER unknown 3–4 hr 8–24 hr
Therapeutic: opioid analgesics IM 10–30 min 30–60 min 4–5 hr
Pharmacologic: opioid agonists Subcut 20 min 50–90 min 4–5 hr
Schedule II Rect unknown 20–60 min 3–7 hr
IV rapid 20 min 4–5 hr
Pregnancy Category C Epidural 6–30 min 1 hr up to 24 hr
IT rapid (min) unknown up to 24 hr
Indications
Severe pain (the 20 mg/mL oral solution concentration should only be used in Contraindications/Precautions
opioid-tolerant patients). Management of moderate to severe chronic pain in patients Contraindicated in: Hypersensitivity; Some products contain tartrazine, bisul-
requiring use of a continuous around-the-clock opioid analgesic for an extended pe- fites, or alcohol and should be avoided in patients with known hypersensitivity; Acute,
riod of time (extended/sustained-release). Pulmonary edema. Pain associated with mild, intermittent, or postoperative pain (extended/sustained-release); Significant
MI. respiratory depression (extended/sustained-release); Acute or severe bronchial
asthma (extended/sustained-release); Paralytic ileus (extended/sustained-release).
Action Use Cautiously in: Head trauma;qintracranial pressure; Severe renal, hepatic,
Binds to opiate receptors in the CNS. Alters the perception of and response to painful or pulmonary disease; Hypothyroidism; Seizure disorder; Adrenal insufficiency; His-
stimuli while producing generalized CNS depression. Therapeutic Effects: De- tory of substance abuse; Undiagnosed abdominal pain; Prostatic hyperplasia; Patients
crease in severity of pain. Addition of naltrexone in Embeda product is designed to undergoing procedures that rapidly p pain (cordotomy, radiation); long-acting
prevent abuse or misuse by altering the formulation. Naltrexone has no effect unless agents should be discontinued 24 hr before and replaced with short-acting agents;
the capsule is crushed or chewed. Geri: Geriatric or debilitated patients (dosepsuggested); OB, Lactation: Avoid
chronic use; has been used during labor but may cause respiratory depression in the
Pharmacokinetics
newborn; Pedi: Neonates and infants ⬍3 mo (more susceptible to respiratory de-
Absorption: Variably absorbed (about 30%) following oral administration. More pression); Pedi: Neonates (oral solution contains sodium benzoate which can cause
reliably absorbed from rectal, subcut, and IM sites. Following epidural administra-
potentially fatal gasping syndrome).
tion, systemic absorption and absorption into the intrathecal space via the meninges
occurs. Adverse Reactions/Side Effects
Distribution: Widely distributed. Crosses the placenta; enters breast milk in small CNS: confusion, sedation, dizziness, dysphoria, euphoria, floating feeling, hallucina-
amounts. tions, headache, unusual dreams. EENT: blurred vision, diplopia, miosis. Resp:
Protein Binding: Premature infants: ⬍20%; Adults: 35%. RESPIRATORY DEPRESSION. CV: hypotension, bradycardia. GI: constipation, nausea,
Metabolism and Excretion: Mostly metabolized by the liver. Active metabolites vomiting. GU: urinary retention. Derm: flushing, itching, sweating. Misc: physical
excreted renally. dependence, psychological dependence, tolerance.
⫽ Canadian drug name. ⫽ Genetic Implication. CAPITALS indicate life-threatening, underlines indicate most frequent. Strikethrough ⫽ Discontinued.
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