MSIR Protocol Question

  1. Have a question and would like experiences. When titrating MSIR for pain/sob, assuming MSIR 0.25-2.0ml q1-4 hrs prn po. It is good to start out low and move up for dosage, but if pain increases is it more effective to shorten time between and then increase dosage ml slowly? Just would like to hear experiences. Thanks.
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    Joined: Oct '08; Posts: 5


  3. by   mc3
    My experience is to do both. Increase dose and timing until pt is comfortable. Also consider using adjunct (ativan), especially with SOB. Remember, morphine and ativan together are the gold standard in hospice care at eol.