Clinical Medications WorksheetsGeneric Namemorphine

Trade NameAstramorph

ClassificationOpioid analgesic

Dose2mg-4mg

RouteIV

Time/frequencyQ 3 hrs

Peak20 min

Onsetrapid

Duration4-5 hrs

Normal dosage rangeUsual starting dose for moderate to severe pain in opioid-naive patients--4-10 mg q 3-4 hr.Rate: Administer 2.5-15 mg over 4-5 min. Rapid administration may lead to increased respiratory depression, hypotension, and circulatory collapse

Why is your patient getting this medicationPain

For IV meds, compatibility with IV drips and/or solutionsSolution is colorless; do not administer discolored solution. Dilute with at least 5 ml of sterile water or 0.9% NaCl for injection to a concentration of 0.5-5 mg/mlY-Site Incompatibility: amphotericin B cholesteryl sulfate, azithromycin, cefepime, doxorubicin liposome, minocycline, phenytoin, sargramostim

Mechanism of action and indications(Why med ordered)Binds to opiate receptors in the CNS. Alters the perception of and response to painful stimuli while producing generalized CNS depression

Nursing Implications (what to focus on) Contraindications/warnings/interactionsHypersensitivity, Some products contain tartrazine, bisulfites, or alcohol and should be avoided in patients with known hypersensitivity

Common side effectsconfusion, sedation, RESPIRATORY DEPRESSION, hypotension, constipation

Interactions with other patient drugs, OTC or herbal medicines (ask patient specifically)Detrol: Coadministration of narcotic analgesics with anticholinergic agents may have additive central nervous system (CNS) and gastrointestinal (GI) system effects, and increase the risk of severe constipation or paralytic ileus and CNS depression.Baclofen: Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these effects, especially in elderly or debilitated patients.Norvasc: The concomitant administration of agents with hypotensive effects and psychotherapeutic agents (e.g., anxiolytics, sedatives, hypnotics, antidepressants, antipsychotics), narcotic analgesics, alcohol, or muscle relaxants may additively increase hypotensive and/or central nervous system depressant effects.

Lab value alterations caused by medicineMay ↑ plasma amylase and lipase levels

Be sure to teach the patient the following about this medicationInstruct patient how and when to ask for pain medication. May cause drowsiness or dizziness. Caution patient to call for assistance when ambulating or smoking and to avoid driving or other activities requiring alertness until response to medication is known. Advise patient to change positions slowly to minimize orthostatic hypotension. Caution patient to avoid concurrent use of alcohol or other CNS depressants with this medication. Encourage patients who are immobilized or on prolonged bedrest to turn, cough, and breathe deeply every 2 hr to prevent atelectasis.

Nursing Process- Assessment(Pre-administration assessment)Assess type, location, and intensity of pain prior to and 20 min (peak) following IV administration. Assess level of consciousness, blood pressure, pulse, and respirations before and periodically during administration. Assess bowel function routinely.

AssessmentWhy would you hold or not give this med?If respiratory rate is <10/min, assess level of sedation. Toxicity (administer Narcan)

EvaluationCheck after givingDecrease in severity of pain without a significant alteration in level of consciousness or respiratory status