#morphine sulfate

[spooniestrong]

Urgent medicine recall: A serious dosage mistake can lead to overdose and death

Bryant Ranch Prepack issued a recall for two lots of Morphine Sulphate lots as the bottles come with labels showing incorrect dosages.

[jazznoisehere]

Original artwork by Ben Frost - rebuilt by me.

[mastercontrol]

Morphine Sulfate pill (15mg)

[ptmasterguide]

Morphine Sulfate (Dosage)

In this article, we will discuss Morphine Sulfate (Dosage). So, let’s get started. Morphine sulfate 0.1-0.2 mg/kg/dose SC, maximum dose 15 mg. It is given IV 2-5 mg/dose for preoperative medication, postoperative pain, restlessness, pulmonary edema. For continuous infusion in neonates 0,01-0,02 mg/kg/hr, infants and children 0.025-0.2 mg/kg/hr. Mechanism of Action Morphine, a full opioid…

View On WordPress

[siglerprescriptiondrugcards]

Morphine Sulfate

This medication is a Schedule II drug.

Common Brand Names: Duramorph, Astramorph/PF

Therapeutic Class: A semi-synthetic phenanthrene-derivative opiate analgesic

Common Injectable Dosage Forms: Injection: In concentrations ranging from 0.5-50 mg/mL in various size containers for use as IM, IV, epidural, or intrathecal administration

Dosage Ranges:

Should be given in the smallest effective dose and frequency in order to minimize the development of tolerance and/or physical dependence. The usual range for SQ or IM doses is 5-20 mg every 4 hours as necessary, with IV doses ranging from 2.5-15 mg every 4 hours.

Children’s doses range from 0.05-0.2 mg/kg IM or IV every 4 hours as necessary with single doses not to exceed 15 mg. Continuous IV infusion has been initiated at 0.8-10 mg/hour and titrated as high as 150 mg/hour to achieve pain control, with pediatric doses ranging from 0.025-2.6 mg/kg/hour.

Epidural analgesia has been achieved with doses of 5-10 mg, and intrathecal dosages are approximately 1/10th the equivalent epidural dose. The routes should only be given by physicians experienced in the respected techniques of administration.

Administration and Stability: Morphine sulfate is given undiluted when administered by the intrathecal and epidural routes. Intravenous administration can be accomplished by mixing with 4-5 mL of Water for Injection and given over a 5-minute period. For continuous infusion, prepare a 0.1-1 mg/mL solution using 5% Dextrose in Water and administer using a controlled-infusion device. pH 3.5-6.5

Pharmacology/Pharmacokinetics: Opiate agonists exert their principal pharmacologic effect on receptors at several systems of neurotransmitters to produce analgesia. However, their precise mechanism of action has not been fully elucidated. The drugs alter the perception of pain at the spinal cord and higher levels in the CNS. They also alter the patient’s emotional response to pain. Onset of action is usually 15-30 minutes and analgesia is maintained for 4-8 hours, depending on the route of administration. Metabolism occurs in the liver by glucuronidation. Excretion in the urine as the conjugate is the primary route of elimination.

Drug and Lab Interactions: Opiates may potentiate the effects of other CNS DEPRESSANTS including other opiate agonists, general anesthetics, tranquilizers, sedatives, hypnotics, alcohol, and other CNS drugs such as MAO inhibitors and tricyclic antidepressants. Opiate agonists may also decrease the effects of diuretics in patients with congestive heart failure.

Contraindications/Precautions: Caution should be used in administering to patients with known hypersensitivity to other opiate agonists. Morphine should also be used with caution in patients with hepatic or renal dysfunction, and also in patients with chronic respiratory problems. Individuals who perform hazardous tasks requiring mental alertness and/or physical coordination should be warned about adverse effects of opiate agonists. Injectable naloxone hydrochloride should be readily available in case of severe adverse reactions. Pregnancy Category C/D.

Monitoring Parameters: Pain relief, respiratory and mental status, and blood pressure

Adverse Effects: Respiratory and/or circulatory depression are the chief hazards to opiate agonist therapy as respiratory arrest, shock, and cardiac arrest have occurred. Other CNS adverse effects include dizziness, sedation, coma, dysphoria. Less serious side effects reported include nausea, vomiting, constipation, changes in biliary tract pressure, and urinary retention. Tolerance, psychological and physical dependence may also occur in patients receiving opiate agonists.

Common Clinical Applications: A strong analgesic used in the relief of severe acute and chronic pain, for preoperative sedation, as supplement to anesthesia, and for analgesia during labor.

[siglerprescriptiondrugcards]

The medication is a Schedule II drug.

Brand Names: MS Contin, Avinza, Kadian

Generic Available

Common Dosage Forms:

Tablets (MS Contin): 15 mg, 30 mg, 60 mg, 100 mg, 200 mg

Capsules (Avinza): 30 mg, 45 mg, 60 mg, 75 mg, 90 mg, 120 mg

Capsules (Kadian): 10 mg, 20 mg, 30 mg, 40 mg, 50 mg, 60 mg, 70 mg, 80 mg, 100 mg, 130 mg, 150 mg, 200 mg

*100 mg and above doses are for opioid-tolerant patients only

FDA Indications/Dosages:

For the relief of moderate to severe pain for use in patients who require repeated dosing with potent opioid analgesics over periods of more than a few days*: 15-400 mg daily in a single (capsule) or divided (tablet) dose.

Conversion from immediate-release oral morphine to extended-release morphine: Either administer one-half of the patient’s 24-hour requirement as an extended-release tablet on an every 12-hour schedule or administer one-third of the patient’s daily requirement on an every 8-hour schedule.

Conversion from parenteral morphine or other opioids, parenteral or oral, to extended-release morphine: Estimates of the relative potency of opioids are only approximate and are influenced by route of administration, individual patient difference, and possibly, by an individual’s medical condition. Consequently, it is difficult to recommend any fixed rule for converting a patient to extended-release morphine directly. For morphine, it is suggested that the oral morphine dosage only three times the daily parenteral morphine requirement in chronic use settings. For other parenteral or other oral opioids, physicians are advised to refer to published relative potency data, keeping in mind that such ratios are only approximate. In general, it is safer to underestimate the daily dose of extended-release morphine required and rely upon ad hoc supplementation to deal with inadequate analgesia. The 200 mg tablet is for use only in opioid tolerant patients requiring daily morphine equivalent dosage of 400 mg or more.

*Because it may be more difficult to titrate a patient using controlled-release morphine, it is advised to begin treatment using an immediate-release morphine formulation.

Pharmacology/Pharmacokinetics: Morphine produces analgesia by a central action on the central opiate receptors. Following an oral administration of a given dose of morphine, the amount ultimately absorbed is essentially the same whether the source is an extended-release or a conventional formulation. Morphine usually has an onset of action between 15-60 minutes, with a peak occurring between 30-60 minutes. The terminal elimination half-life of morphine is normally 2-4 hours. The elimination of morphine occurs primarily as renal excretion of 3-morphine glucuronide. A small amount of the glucuronide conjugate is excreted in the bile, and there is some minor enterohepatic recycling.

Drug Interactions: May enhance the actions of phenothiazine, general anesthetics, sedatives, hypnotics, alcohol, skeletal muscle relaxants, and agonist/antagonist analgesics. If testing for enzyme levels, narcotics may increase biliary tract pressure and subsequently increase amylase or lipase levels.

Contraindications/Precautions: Contraindicated on patients with respiratory depression in the absence of resuscitative equipment, and in patients with acute or severe bronchial asthma. Extended-release forms are contraindicated in any patient who has or is suspected of having paralytic ileus. Use with caution in patients with problems in blood pressure, head injury, severe hepatic or renal impairment, Addison’s disease, hypoparathyroidism, prostatic hypertrophy or urethral stricture, supraventricular tachycardia, seizure disorders, acute abdominal conditions, in pregnancy or lactation, and in asthma, or other respiratory-compromising conditions. OPIOIDS CAN BE ADDICTIVE, ABUSED, AND MISUSED WHICH CAN LEAD TO OVERDOSE AND DEATH. SERIOUS, LIFE-THREATENING RESPIRATORY DEPRESSION MAY OCCUR. ACCIDENTAL EXPOSURE CAN BE FATAL, ESPECIALLY IN CHILDREN. USE IN PREGNANCY CAN CAUSE NEONATAL WITHDRAWAL SYNDROME. CONCOMITANT USE WITH BENZODIAZEPINES, ALCOHOL, OR OTHER CNS DEPRESSANTS CAN RESULT IN RESPIRATORY DEPRESSION, COMA, AND DEATH. Pregnancy Category C.

Adverse Effects: Constipation, lightheadedness, dizziness, sedation, nausea, vomiting, sweating, dysphoria, and euphoria.

Patient Consultation:

Tablets must be taken whole, and are not to be broken, chewed, or crushed. Taken broken, chewed, or crushed extended-release formulations could lead to rapid release and absorption of a potentially toxic dose of morphine.

May cause drowsiness. Use caution while operating machinery or when mental alertness is required.

May take with food or milk to avoid GI upset.

WARNING: This medication may be habit-forming.

The prescription cannot be refilled.

Store in a cool, dry place away from sunlight and children.

Contact a physician if the above side effects are severe or persistent.

If a dose is missed, take it as soon as possible and reschedule your remaining doses based upon the schedule your physician prescribed. Do not double doses.

[vortexstreet]

Damien Hirst, from the Last Supper, 1999, Screenprint, 153 x 102 cm, Edition of 150