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Pronunciation

MOR-feen

Classifications

Therapeutic Classification: opioid analgesics

Pharmacologic Classification: opioid agonists

Indications

High Alert


Action

  • Binds to opiate receptors in the CNS. Alters the perception of and response to painful stimuli while producing generalized CNS depression.
Therapeutic effects:
  • Decrease in severity of pain.

Pharmacokinetics

Absorption: Variably absorbed (about 30%) following oral administration. More reliably absorbed from rectal, SUBQ, and IM sites. Following epidural administration, systemic absorption and absorption into the intrathecal space via the meninges occurs.

Distribution: Widely distributed to tissues.

Metabolism/Excretion: Mostly metabolized by the liver. Active metabolites excreted renally.

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 sickle cell disease: 1.3 hr; Adults: 2–4 hr.

Time/Action Profile

(analgesia)

ROUTEONSETPEAKDURATION
POunknown60 min4–5 hr
PO-ERunknown3–4 hr8–24 hr
IM10–30 min30–60 min4–5 hr
SUBQ20 min50–90 min4–5 hr
Rectunknown20–60 min3–7 hr
IVrapid20 min4–5 hr
Epidural6–30 min1 hrup to 24 hr
ITrapid (min)unknownup to 24 hr



Contraind./Precautions

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects

CV: hypotension, bradycardia

Derm: flushing, itching, sweating

EENT: blurred vision, diplopia, miosis

Endo: adrenal insufficiency

GI: constipation, nausea, vomiting

GU: urinary retention

Neuro: confusion, sedation, dizziness, dysphoria, euphoria, floating feeling, hallucinations, headache, unusual dreams

Resp: RESPIRATORY DEPRESSION (INCLUDING CENTRAL SLEEP APNEA AND SLEEP-RELATED HYPOXEMIA)

Misc: allodynia, opioid-induced hyperalgesia, physical dependence, psychological dependence, tolerance

Interactions

Drug-drug:

Drug-Natural Products:

Route/Dosage

Availability

(Generic available)

Assessment

Lab Test Considerations:

Toxicity and Overdose:

Implementation

IV Administration:

Patient/Family Teaching

Evaluation/Desired Outcomes

US Brand Names

AVINza, Duramorph, Embeda, Infumorph, Mitigo, Morphabond ER, MS Contin, Roxanol

Canadian Brand Names

Doloral, Kadian, M-Eslon, Morphine LP Epidural

Contr. Subst. Schedule

Schedule II (C-II)

Code

NDC Code