Morphine dose in vial? - page 3
by Chaya | 5,958 Views | 29 Comments
So at both of the places I have worked (Med-Surg settings) the most common dose prescribed for IV morphine is 2 mg. However, it is dispensed in 5 mg vials. This means we need to do a witnessed waste for 80-90% of the patients who... Read More
- 0Jun 1, '11 by ChayaThank you all for the feedback. I couldn't believe that no-one makes a 2 mg dose if there is as high a demand for it as I thought there was. According to our pharmacy (and the one at my last job also) it doesn't seem to be available to us. I don't know if that is a regional supplier thing or what the problem is (we are located in the Metro Boston area). Our pharmacists say we could get syringes but the Pyxis wouldn't hold as many doses. (Are carpujets those syringe-type cartridges that you need to have a plastic piston type device to use with it?)
As for taking vials, etc home- we used to be able to draw up the dose and discard the vial in the sharps container in the med room with our witness but now we have to scan the actual vial at the patient's bedside. I've removed any number of alcohol wipes and "refused" colace caps from my washer/ dryer but have managed to catch myself before leaving with anything worse!
Oh, and Reno1978- love your lime cadet pussycat!
- 0Jun 2, '11 by JBudd GuideWe have 2 and 10 mg carpujects. We used to have the 2mg Dilaudid carpuject, but the pharm tech loaded Dilaudids in the Morphine drawer, and 3 patients got the wrong stuff (what happened to reading the dang label three times!!!?). 3 different nurses, arghh!! Took me a while to chase it all down and do the incident reports.
Considered a sentinel event, and we now only have 1 mg Dilaudids to get rid of the look-alike problem.
When my late dh had CA, I had the 15mg/ml Morphine vials at home.
I've been told the packaging is what is expensive, not the volume of drug; so they may buy the larger dose to save money. After all, having to pull 2 vials for a 2 mg dose costs more, and who cares if it takes up nurses' time to have to waste all the time.
- 0Jun 3, '11 by psu_213, BSN, RNQuote from DeLanaHarvickWannabeWe have an MD who does not believe flexeril (sp?) is effective so he almost always uses valium and a muscle relaxant. When he orders it IV, it is usually 4 mg. Our IV valium comes as 10mg/2mL. Another waste...plus the importance of being able to do basic med math.And, the one that annoys me, Ativan is ONLY in 2 mg.
- 0Jun 3, '11 by talaxandraWow, the things I never realised would be different! We stock morphine in 10mg, 30mg and 120mg ampoules; I was always taught that standard dosing (ie acute pain in opiate-naÔve patients) was 1mg/10kg (or roughly 22lb), which fits with our usual dosing of 2.5mg to 10mg as an IV push or SC/IM injection.
Though the larger ampoules are mostly used for infusions (we prep on the wards and don't have 24/24 pharmacists), I've had at least one chronic pain patient who was having 30mg 4/24 IM.
From a waste POV - morphine's not very expensive, and most of the associated cost is the packaging and regulatory oversight (ie making sure none of it goes missing in the manufacturing process).