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warnings
WARNINGS Morphine can cause tolerance, psychological and physical dependence. Withdrawal will occur on abrupt discontinuation or administration of a narcotic antagonist. Interaction with Other Central-Nervous-System Depressants Morphine should be used with caution and in reduced dosage in patients who are concurrently receiving other narcotic analgesics, general anesthetics, phenothiazines, other tranquilizers, sedative-hypnotics, tricyclic antidepressants, and other CNS depressants (including alcohol). Respiratory depression, hypotension, and profound sedation or coma may result.
ADVERSE REACTIONS THE MAJOR HAZARDS OF MORPHINE, AS OF OTHER NARCOTIC ANALGESICS, ARE RESPIRATORY DEPRESSION AND, TO A LESSER DEGREE, CIRCULATORY DEPRESSION, RESPIRATORY ARREST, SHOCK, AND CARDIAC ARREST HAVE OCCURED. The most frequently observed adverse reactions include lightheadedness, dizziness, sedation, nausea, vomiting, and sweating. These effects seem to be more prominent in ambulatory patients and in those who are suffering severe pain. In such individuals, lower doses are advisable. Some adverse reactions may be alieviated in the ambulatory patient if he lies down. Other adverse reactions include the following: Central Nervous System - Euphoria, dysphona, weakness, headache, insomnia, agitation, disonentation, and visual disturbances. Gastrointestinal - Dry mouth, anorexia, constipation, and biliary tract spasm. Cardiovascular - Flushing of the face, bradycardia, palpitation, faintness and syncope. Allergic -Pruritus, urticana, other skin rashes, edema, and, rarely hemorrhagic urticana. Treatment of the most frequent adverse reactions Constipation Ample intake of water or other liquids should be encouraged. Concomitant administration of a stool softener and a peristatic stimulant with the narcotic analgesic can be an effetive preventive meassure for those patients in need of therapeutics. If elimination does not occur for two days, an enema should be administered to prevent impaction. In the event diarrhea occurs, seepage around fecal impaction is a possible cause to consider before antidiarrheal measures are employed. Nausea and Vomiting Phenothiazines and antihistamines can be effective treatments of nausea of the medullary and vestibular sources respectively. However, these drugs may potentiate the side effects of the narcotic or the anti-nauseant. Drowsiness (sedation) Once pain control is achieved, undesirable sedation can be minimized by titrating the dosage to a level that just maintains a tolerable pain or pain free state.