Morphine and preload reduction - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
USMLE Articles
Go Back   USMLE Forums > USMLE Step 2 CK Forum

USMLE Step 2 CK Forum USMLE Step 2 CK Discussion Forum: Let's talk about anything related to USMLE Step 2 CK exam

Thread Tools Search this Thread Display Modes
Old 10-15-2011
USMLE Forums Scout
Steps History: 1+CK+CS
Posts: 92
Threads: 41
Thanked 46 Times in 18 Posts
Reputation: 56
Heart Morphine and preload reduction

How exactly does Morphine reduces preload in cases as acute pulmonary edema?
Reply With Quote Quick reply to this message

Old 10-15-2011
USMLE Forums Master
Steps History: 1+CK+CS+3
Posts: 515
Threads: 88
Thanked 508 Times in 232 Posts
Reputation: 518

The first thing is the vasodilator effects of morphine. Allows more blood flow, lowering pressures -> Allows the heart to work more effectively -> less fluid gets stuck in the pulmonary structures. Then relieve shortness of breath and anxiety.
Reply With Quote Quick reply to this message
The above post was thanked by:
Krazy (11-21-2013), meanmr.mustard (10-15-2011)
Old 10-15-2011
Hokolesqua's Avatar
USMLE Forums Veteran
Steps History: 1+CK+CS
Posts: 262
Threads: 6
Thanked 371 Times in 154 Posts
Reputation: 381

Use of morphine sulfate in CPE for preload reduction has been commonplace for many years. Good evidence supporting a beneficial hemodynamic effect is lacking. Data suggest that morphine sulfate may contribute to a decrease in cardiac output and that it may be associated with an increased need for ICU admission and endotracheal intubation.

Adverse effects (eg, nausea and vomiting, local or systemic allergic reactions, respiratory depression) may outweigh any potential benefit, especially given the availability of medications that are more effective than morphine in reducing preload (eg, NTG).

Any beneficial hemodynamic effect is probably due to anxiolysis, with a resulting decrease in catecholamine production and decrease in systemic vascular resistance. An alternative can be low-dose benzodiazepines (eg, lorazepam 0.5 mg IV) in patients who are extremely anxious. This alternative reduces the risk of respiratory depression in patients whose condition responded to initial therapy.

Reply With Quote Quick reply to this message
The above post was thanked by:
goodbadugly (08-17-2014), Krazy (11-21-2013), meanmr.mustard (10-15-2011)


Cardiology-, Internal-Medicine-

Quick Reply

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Please enter a password for your user account. Note that passwords are case-sensitive.
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Where you live. Leave blank if you don't want to tell.


Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.

Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes

Similar Threads
Thread Thread Starter Forum Replies Last Post
Effect of Squatting on Preload??? steps275 USMLE Step 1 Forum 10 01-03-2017 08:43 PM
CHF and preload drzamzam USMLE Step 1 Forum 0 07-30-2011 08:15 AM
Preload & CHF drzamzam USMLE Step 1 Forum 0 07-27-2011 08:19 AM
Morphine side effects Mnemonic earthpole USMLE Step 1 Mnemonics 0 06-04-2011 10:15 AM
Residency years reduction 1TA2B IMG Residency Match Forum 2 02-02-2011 02:55 PM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)