【藥品性質提示】 根據 2019 AGS Beers Criteria，本藥品為【潛在不適當用藥 (PIM)】，不建議用於有骨折風險之老年人(除非用於急性止痛)。 #建議持續輸注 (IV pump) 之高警訊藥品

鴉片類止痛 Relief of visceral pain, preanesthetic medication

Opioid Analgesic
Binds to opioid receptors in the CNS, causing inhibition of ascending pain pathways, altering the perception of and response to pain; produces generalized CNS depression.

Onset of action:
IV: 5-10 min
Metabolism:
Morphine is inactivated in the liver, primarily by conjugation to morphine-6-glucuronide (active) and morphine-3-glucuronide (inactive or antagonistic)
Excretion:
Mostly excreted in urine; Accumulation of morphine-6-glucuronide might cause toxicity with renal insufficiency

1. Hypersensitivity to morphine or any component of the formulation
2. Severe respiratory depression (without resuscitative equipment)
3. Acute or severe asthma
4. Known or suspected paralytic ileus, acute pancreatitis, increased intracranial pressure
5. Sustained release products are not recommended with gastrointestinal obstruction or in acute/postoperative pain

Prolonged use of morphine during pregnancy can result in neonatal opioid withdrawal syndrome, which may be life-threatening.

1. Nonopioid analgesics are preferred for breastfeeding females who require pain control peripartum or for surgery outside of the postpartum period.
2. When opioids are needed in breastfeeding women, the lowest effective dose for the shortest duration of time should be used.

Respiratory and circulatory depression, constipation, miosis, drowsiness, bradycardia, hypotension, sedation, dizziness, nausea, vomiting, sweating

SC: 5-15 mg Q4h
IV: 4-10 mg, dilute and inject slowly over a 2-3 min period
IV infusion: 0.8-10 mg/hr, some patients with chronic pain may require a higher dosage
IM: painful, not recommended

IV: 0.05-0.2 mg/kg Q4h
IV infusion 0.01-0.04 mg/kg/hr

1. Clcr 10-50 mL/min: Administer at 75% of normal dose
2. Clcr <10 mL/min: Administer at 50% of normal dose

1. Pharmacokinetics unchanged in mild liver disease; substantial extrahepatic metabolism may occur.
2. In cirrhosis, increases in half-life and AUC suggest dosage adjustment required.