[Midge]

Have just spent most of the day searching Google and other sources for info on nebulized MSo4 for the pharmacist so I can get the proper stuff for my home hospice patient whose COPD is about to do him in. I used it for years at an inpatient hospice in Boston, but never had any pharm specs for it. The pharmacist was adamant about needing to know about sterility and preservatives. Reading the posts I see that even Roxanol is being used - how simple that would be! All of the reams of paper I have now with articles have NO info on which MS04 to use. Any pharmacists out there? Thanks for the help.

[NRSKarenRN]

See previous thread Preservative free Morphine:

Nebulized drugs in palliative care

Some, but not all, clinicians use preservative-free opioid preservative-free opioid preparations in an attempt to reduce the risk of bronchospasm. If morphine is employed then the intravenous formulation should be used and not the oral elixir.
Includes drug delivery chart
http://www.brit-thoracic.org.uk/pdf...sPalliative.pdf

Doses initially of 5mg morphine diluted in either 2ml or 5ml 0.9% sodium chloride or water and nebulised over 15 minutes have been used. This dose may be repeated four hourly. If shortness of breath recurs in less than four hours or it the patient does not significantly improve then the dose may be increased by 25 - 30%. The maximum dose of morphine recommended is 30mg. Preservative free solutions are preferred when preparing doses as the presence of preservatives have been found to cause bronchoconstriction and bronchitis in some patients
http://www.stjames.ie/nmic/qa.html

Link has other articles:
http://allnurses.com/forums/showthre...spnea+morphine

[tex]

I have many years experience using Morphine along with the patients other neub tx's. This morphine that is to relax the muscles/lungs, does not interfer with their regular dose of morphine for pain. The Morphine used can not have any perservatives............That is the secret..........It is absolutely the best thing you can do for your pt/ The patient will not c/o of any taste..............TEX

[tex]

Can call Pine Pharmacy in Niagaria Falls, N.Y. , They were the experts...compounded anything and everything, down to what flavor the pt wanted in regard to liq or SL pain meds. Ask them about Gralla for n/v that can be administered topically as well as po or PR Tex