[tex]

One suggestion, remember if your patient is thin, duragesic patches are not your answer. Your patient has to have some body fat. Placing a patch on someone that is clearly boney is a waste of medication. I am from the school, that you do not have to stick your patient with one needle to provide relief from pain. Depending on where you live. You need a pharmacy that does compound mixing. I even had a pharmacy that would deliver to the area hospital's if the hospital wasn't able to compound. If your patient can swallow, morphine release is in 200 mg doses, and my patients have taken up to 5 qd with morphine concentrate for breakthrough sL. Dilaudid is wonderful in SL form also. You can compound it with how many mg per gtt. But I learned any time you administer over 4 gtts at a time, thrush or soreness of the mouth can present itself. Another wonderful drug for your lung, respiratory illness's. Is to get morphine in vial to adminster it along with your other respiratory medications via their neub. The trick is to make sure that the morphine is preservative free. It will not interfer with your other morphine that is intended for pain. What it does is relax the muscles in the lungs and allows your patient to breathe easier. Good luck Tex

[aimeee]

Tex--you can get Dilaudid compounded as an SL liquid? I've never heard of this. Did a private or hospital pharmacy compound this for you?

[tex]

Yes you can get it compounded, matter of fact you can get flavors. A pharmacy in Niagaria Falls did it for me. It is so many mg per gtt. I live in NC now and I can get it here also. You need to find also a pharmacy that has the ability to make suckers that are for pain, nausea all in one. Ususally the patient can suck this sucker for around a min or so. It is a beautiful thing Tex

[aimeee]

INTERESTING!

I've heard of the suckers that are a form of fentanyl, haven't seen them myself...but I'm told they are VERY expensive...of course, those are brand name. I'm told they are a BIG nuisance when you have to waste them too. What else have you seen compounded in a sucker? Do they use compazine in them too for the nausea component? And how do you approach dosing if the patient doesn't consume the whole sucker?

[tex]

Forget the suckers if you are able to assess that the patient won't be utilizing it. We did have a name of Gralla, a topical oint that was measured out like nitro. Its sole purpose was for nausea/ You can call in Niagaria Falls, NY the pharmacy that compounds these meds. I will try to remember the name of the place and get back to you. But it is on Pine Ave. The pharm. are sharp. Another source is Niagaria Hospice in Lockport N.Y. you can call them and ask for the pharmacy's name in Niagaria Falls. Hope this helps....Tex

[tex]

The name of the pharmacy that compounds in Niagaria Falls N.Y. is called Pine Pharmacy............these people are great and sharp. Tex

[aimeee]

Thanks, Tex. That info may come in handy sometime!