Contents

Search


aerosolized morphine (nebulized morphine)

Indications: -> relief of dyspnea in palliative care * of no benefit [2]; use oral morphine Dosage: 1) morphine for injection 10 mg/mL 2) 5-20 mg every 3-4 hours PRN Administration: 1) nebulizer (e.g. Pulmoaid) 2) 3 mL normal saline 3) 3 mL syringe with 20 gauge needle & alcohol prep pads 4) albuterol &/or ipratropium (Atrovent) may be added to morphine in nebulizer & administered simultaneously Pharmacokinetics: 1) bioavailability 10-15% 2) loss of drug into atmosphere Adverse effects: 1) GI effects should be less than oral form a) constipation b) nausea 2) fatal respiratory arrest, especially with a) drug abuse b) patients with poorly controlled asthma Mechanism: 1) unknown 2) may be local effects involving afferent nerve pathways

Interactions

drug adverse effects of opiates

General

morphine (morphine sulfate [MS], MS Contin, Roxanol, Oramorph SR, Kadian, Avinza, DepoDur, Duromorph) aerosolized agent

References

  1. Farncombe & Chater, J Pain Symptom Manage 8:221, 1993
  2. Medical Knowledge Self Assessment Program (MKSAP) 17, American College of Physicians, Philadelphia 2015