Analgesia · Opioid (µ agonist)
Morphine
Dose
IV 2.5–5 mg q4h titrated; PO 10–20 mg q4h; SC 5–10 mg q4h
Mechanism
µ-receptor agonist → analgesia, sedation, euphoria
Indications
- • Moderate–severe pain
- • Acute pulmonary oedema (cautious)
- • Palliative dyspnoea
Contraindications
- • Severe respiratory disease without monitoring
- • Acute biliary colic (relative)
Dose adjustment
Reduce in renal impairment — active metabolite M6G accumulates
Use
Workhorse opioid; reduce dose in elderly and renal impairment.
Monitoring
RR, sedation, pain score, pupils, bowels.
Side effects
- • Respiratory depression
- • Constipation
- • Pruritus, urinary retention
- • Hypotension (histamine)
Pregnancy safety
Neonatal withdrawal if chronic
Related in WardRound
STEMI
Protocol · PPCI < 120 min
Acute Heart Failure / Pulmonary Oedema
Protocol · LMNOP
Unstable Angina
Protocol · ACS without troponin rise
Severe Acute Pancreatitis
Protocol · Fluids, analgesia, ICU
Sickle Cell Vaso-Occlusive Crisis
Protocol · Analgesia + hydration + O₂
Major Burns
Protocol · Parkland + airway + escharotomy
Acute Coronary Syndrome
Topic · Cardiology
Parkinson Disease
Topic · Neurology
Last Days of Life Care
Topic · Palliative Care
Always confirm dose against your local formulary / BNF before prescribing.
