Morphine dose in vial? - page 3

by Chaya

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


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    Thank 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!

    Anyway I don't know if we are allowed under AN terms of use to mention manufacturer's by name but if anyone is comfortable doing so I would like to pass them along to our pharmacy. You could PM me (or tell me the name of hospitals where you have used the prepackaged 2 mg dose and I can have our pharmacy contact theirs)

    Oh, and Reno1978- love your lime cadet pussycat!
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    2, 4 and 10 mg carpuject.

    dilaudid is 2mg.
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    We have 2mg and 4mg carpuject syringes and 10ml vials.
    The doses I give most often are 2 or 4mg. I hate it when the MD orders 5mg and I have to waste half of a 10mg vial!
  4. 0
    Quote from Chaya
    (Are carpujets those syringe-type cartridges that you need to have a plastic piston type device to use with it?)
    Yes, that's a carpuject!
  5. 0
    Quote from Chaya
    Anyway I don't know if we are allowed under AN terms of use to mention manufacturer's by name but if anyone is comfortable doing so I would like to pass them along to our pharmacy. You could PM me (or tell me the name of hospitals where you have used the prepackaged 2 mg dose and I can have our pharmacy contact theirs)
    Our morphine carpuject syringes are manufactured by Hospira.
    http://products.hospira.com/search/p...=ndc&order=asc
  6. 0
    We have 2mg, 4mg and 10 mg available for Morphine.

    For Dilaudid, we have 1 mg and 4 mg.

    And, the one that annoys me, Ativan is ONLY in 2 mg.
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    We 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.
  8. 0
    Quote from DeLanaHarvickWannabe
    And, the one that annoys me, Ativan is ONLY in 2 mg.
    We 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.
  9. 0
    Wow, 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-na´ve 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).
  10. 0
    A bit off topic but does anyone see much use of PCA ( patient controlled analgesic) pumps in chronic pain patients? Many of the patients that I care for have a PCA ordered if they are getting frequent PRN morphine (usually palliative or fresh post op patients).


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