Question

Identify the therapeutic class, drug form, use, action, adverse reaction, contraindication use and nursing care and teaching for the following drugs; Morphine

Answer 1

• Therapeutic class- opioid analgesics
• Drug form- tablets, injection, oral solution, rectal suppositories
• Use- severe pain, pulmonary edema, pain associated with MI
• Action- binds to opiate receptors in the central nervous system. It alters the perception and response to painful stimuli while producing generalized CNS depression.
• Adverse reactions-

1. CNS- Sedation, dizziness, dysphoria, headache, hallucinations
2. ENT- blurred vision, miosis, diplopia
3. Respiratory- respiratory depression
4. CV- hypotension, bradycardia
5. Endocrine- adrenal insufficiency
6. GI- constipation, nausea, vomiting
7. GU- urinary retention
8. Integumentary- flushing, itching, sweating
9. Miscellaneous- tolerance, physical and psychological dependence.

• Contraindications- hypersensitivity, post operative pain, significant respiratory depression, acute or severe bronchial asthma, Paralytic ileus.
• Nursing care-

1. Assess level of consciousness, blood pressure, pulse and respirations before and during administration.
2. Assess bowel function routinely
3. Assess risk for opioid addiction, abuse or misuse
4. Explain therapeutic value of medication

• Teaching-

1. Instruct patient how and when to ask for pain medication
2. Advise patient to change position slowly to minimize orthostatic hypotension
3. Caution patient to avoid concurrent use of alcohol
4. Advise patient to notify health care professional if pregnancy is planned or suspected or if breast feeding
5. Encourage patients who are immobilized or on prolonged bed rest to turn, cough and breathe deeply every 2 hour to prevent atelectasis.