Katrika-found this info doing oggle search. Check out the articles, very informative
Nebulised 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/...Palliative.pdf
Pulmonary and GI Symptoms at the End of Life
"Inhaled morphine (injectable medication delivered via a nebulizer)should also be considered as a treatment alternative because it may act more quickly and have more direct effects on peripherally mediated dyspnea."
http://www.acponline.org/vas2001/sessions/end_life.htm
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
Management of Common Symptoms
in Terminally Ill Patients: Part II.
Constipation, Delirium and Dyspnea
http://www.aafp.org/afp/20010915/1019.pdf
Pain in the elderly
http://www.nurseweek.com/ce/ce712a.html
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