Quote from skittlebear
If a patient had Morphine Sulfate, 15mg every 12 hours ordered and had a PRN order for Hydrocodone, 10mg 3 times daily...how far apart would you want to give the Hydrocodone from the Morphine. If the Morphine is extended release, does it really matter?
If the Morphine is slow release, then the hydrocodone would be for breakthrough pain. Rx label directions for hydrocodone state it can be given q 4 to 6 hrs. A younger, larger pt might require the hydrocodone sooner than an older or smaller person. Usually the doctors at our hospital will state q 4-6 hrs as opposed to a number of doses during the day.
I can't think of any reason to order morphine q 12 hrs if it isn't extended release.
My hysband broke his hip in a bicycle accident at age 48. His doctor had ordered Toradol IM q 6 hrs and Percocet q 3 - 4 hrs. The nurses interpreted the order that he could have one or the other. I was livid because he was in extreme pain. I had to get the doc to tell the nurses he could have Percocet between the Toradol injections. He was in rehab, so he needed good pain control in order to participate in the PT.
The nurses argued that they had never had a pt who needed so much pain medication. I reminded them that he was 48, in good health, and would generally metabolize pain meds more quickly than their usual hip fx pts who were usually in their 70's or 80's.