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SR tab: Acute overdose with morphine can be manifested by respiratory depression, somnolence progressing to stupor or coma, skeletal muscle flaccidity, miotic pupils, bradycardia, hypotension and death.
A patient airway must be maintained. The pure opioid antagonists are specific antidotes against symptoms from opioid overdose. Other supportive measures should be employed as needed.
Crushing and taking the contents of a controlled release dosage form leads to the release of the morphine in an immediate fashion; this might result in a fatal overdose.
Treatment of morphine overdosage: Administer naloxone 0.4 mg intravenously. Repeat at 2-3 minutes intervals as necessary, or by an infusion of 2 mg in 500 ml normal saline or 5% dextrose (0.004 mg/ml). This infusion should be run at a rate related to the previous bolus doses administered and should be in accordance with the patient's response. Empty the stomach. A 0.02% aqueous solution of potassium permanganate may be used for lavage.
Assist respiration, if necessary. Maintain fluid and electrolyte levels. In the case of Morphine Sulfate Pentahydrate Tablets, the physician should be aware that Sustained Release tablets remaining in the intestine will continue release morphine sulfate for a period of hours.
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