Combination Morphine
Mechanism of Action
Mu-opioid receptor agonist in CNS and peripheral tissues. Reduces perception of pain and emotional response to pain.
Indications
Combination formulation. Severe pain, including post-operative pain, trauma, cancer pain, and acute MI. Essential for lunar medical bay crash kit and surgical support.
Dosing
Standard (Earth)
See Combination prescribing information. IV: 0.1 mg/kg every 3-4h. PO: 10-30 mg every 4h.
Lunar Protocol
Pharmacokinetics likely unchanged in 1/6g. Reduced doses may be effective due to CNS sensitization from radiation and stress — start at 50-75% of standard dose and titrate. Nausea particularly bothersome in low-g environment (vomiting management critical). Respiratory monitoring mandatory.
Storage
Standard
Controlled substance storage. Room temperature.
Lunar (Radiation + Temperature)
Controlled access storage — biometric lock recommended. Radiation-shielded. Maintain 90-day supply minimum. Strict inventory with dual verification. All uses documented in patient record. Radiation slightly degrades solution form — prefer lyophilized powder form for lunar storage.
Supply Chain & Lunar Pharmacy Notes
Controlled substance. Supply chain requires special authorization. Maintain strict inventory. Consider on-demand vs. standing supply model. Emergency request protocol for resupply if stock runs low.
Drug Interactions
MAOIs (severe reaction). CNS depressants. Anticholinergics. Alcohol.
Contraindications
Severe respiratory depression, acute asthma, paralytic ileus. Caution in head injury (masks neurological exam).
Side Effects
Nausea, constipation, sedation, respiratory depression, dependence.
Lunar Alternatives
Fentanyl (more potent, shorter acting, useful for procedures), tramadol (lower dependence potential for moderate pain), ketorolac (non-opioid for acute severe pain).