Morphine

Provider Level

AEMT/RN/Paramedic

Class

Opioid analgesic, Schedule II narcotic

Mechanism of Action

Binds to opioid receptors in the central nervous system to alter the perception of and emotional response to pain. Produces generalized CNS depression and decreases sympathetic tone.

Indications

Moderate to severe acute pain, chest pain associated with acute myocardial infarction, acute cardiogenic pulmonary edema.

Contraindications

Hypersensitivity, respiratory depression, severe asthma or COPD exacerbation, hypotension, volume depletion, undiagnosed head or abdominal injury, suspected traumatic brain injury.

Routes

IV, IO, IM, SQ

Onset / Duration

Onset: 1 to 2 minutes for IV or IO, 15 to 30 minutes for IM. Duration: 2 to 7 hours.

Adverse Effects

Respiratory depression, hypotension, bradycardia, nausea, vomiting, dizziness, altered mental status, pinpoint pupils, histamine release causing bronchospasm or localized urticaria.

Precautions & Interactions

Use caution in patients with hepatic or renal impairment, elderly patients, and those with underlying respiratory disorders. Naloxone must be readily available to reverse effects if respiratory depression occurs.

Special Considerations

Authorized for AEMT, RN, and Paramedic. Continuously monitor respiratory rate, oxygen saturation, end-tidal CO2, and blood pressure. Administer slowly to minimize adverse effects.