Medication 7-592 - Morphine

CMH EMS & MIH Protocols

Scope of Practice:

• Registered Nurse
• Paramedic
• Community Paramedic

Route(s):

• IM/SQ, IO, IV,

Pharmacodynamics (class and mechanism of action):

• Opiate. (CNS depressant. Causes peripheral vasodilation. Decreases sensitivity to Pain. Binds with opiod receptors. Depresses vasomotor centers of brain. Releases histamine. Reduces stimulation of sympathetic nervous system.).

Pharmacokinetics:

• Half-life: 2-3 hours.
• Onset time:
• IM: 10-30 minutes.
• IV: 5 minutes.
• Peak action time:
• IM: 30-60 minutes.
• IV: 20 minutes.
• Duration of action: 4-5 hours.

• Peak	27	54	81	108	135	162	189	216	243	270	297	minutes
  Duration	27	54	81	108	135	162	189	216	243	270	297	minutes

Dosing:

• Refer to specific protocol(s) below for dose(s).

Indications:

• Protocol 2-220 - Chest Pain / Suspected Cardiac Event.
• Protocol 2-660 - Pain Control.

Contraindications:

• Head Injury.
• Volume depletion.

Pregnancy Risk Factor:

• Category C
• Risk not ruled out: Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks. FDA requires a relatively large amount of high-quality data on a pharmaceutical for it to be defined as Pregnancy Category A. As a result of this, many drugs that would be considered Pregnancy Category A in other countries are allocated to Category C by the FDA.

Potential Incompatibilities:

• Medication 7-417 - Heparin.
• Medication 7-702 - Phenergan.

Precautions and Adverse Effects:

• May worsen Bradycardia and heart block in patients with acute inferior wall MI.
• Use caution with acute Asthma.
• May cause dizziness, ALOC, respiratory depression, hypotension, Nausea, Vomiting, lightheadedness, sedation, diaphoresis, euphoria, and/or dysphoria.
• Possible beneficial effect in Pulmonary Edema.

Antidote:

• Medication 7-143 - Benadryl may be used to reduce the histamine reaction caused by Morphine and reduce the incidence and severity of hypotension.
• Medication 7-603 - Narcan.

Controlled Substance Information:

• Schedule II
• High potential for abuse. Abusing the drug can cause severe physical and mental addiction.
• DEA number: 9300.
• Narcotic: Yes.
• Street names: C & M, Cotton Brothers, Dreamer, Emsel, First Line, God’s Drug, Hows, M, Miss Emma, Mister Blue, Morf, Morpho, MS, New Jack Swing, Unkie.

CMH Pre-Hospital Services Mission: "Provide safe, exceptional, and compassionate care to our communities with an emphasis on highly trained and empowered staff."

CMH Mobile Integrated Healthcare Mission: "Provide exceptional, compassionate, and patient-centered care by a mobile collaborative team to improve patient experience, improve quality outcomes, and reduce healthcare costs."

Polk, Hickory, Cedar, & St Clair County EMS Protocols is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.