roxanol in neb treatments - page 2

I have a pt who takes scheduled neb treatments (COPD diagnosis). She takes scheduled ms contin for gastritis pain- roxanol for breakthru. Has anyone ever put the roxanol in a breathing treatment?... Read More

  1. by   NurseAlwaysNForever
    all pts metabolize meds differently. Anyway, Roxanol is a very effective neb treatment as long as not sugar based. It has no effect on pain management at all, merely relaxes the lungs and decreases discomfort. Does not work on the full body system at all.
  2. by   aimeee
    The few studies that have been done don't seem to provide clear results. It seems to be one of those things though that is worth a try.

    nhaled opioids achieve rapid but erratic plasma drug levels. Masood and Thomas[5] demonstrated that nebulized morphine achieved peak plasma levels rapidly in all subjects (within 10 minutes) compared with oral morphine but that the variability was greater-from 10 to 30 minutes. Bioavailability was 5.5% (range, 3.2-7.8%) for delivery by inhalation and 24% (15-33%) after oral administration. A previous study had found that the bioavailability of inhaled morphine in subjects on a ventilator ranged from 9% to 35% (mean, 17%).[6]
    Above quoted from http://www.medscape.com/viewarticle/498328
  3. by   finn11707
    Quote from doodlemom
    We've always used sterile morphine that is meant for injection - still never any good results.
    Yes, I used this in the prior hospice agency. It was quite effective for patient who did not want internal use effects. The hospice agency I work with now state it is not effective and will not authorize neb use, however.
  4. by   pammyf
    Works really well in some cases. Remember to always have patient take po prior to first nebulized administration. There is a potential for a very bad reaction so if roxanol goes into the lungs death can and has occured.
    Copd pts really like it. The systemic effect is 10 to 15 percent thus less constipation and mental changes. Is lovely for helping couphs with the lung cancer pts --and obviously helping shortness of breath! Avoid color roxanol and obviously the purer (mroe sterile) it is, if available, the better.
  5. by   RNandlovingit
    I have never nebulized morphine for a patient in chronic pain. I have however nebulized morphine at end of life for respiratory distress. And let me tell you it works wonders. It relaxes the bronchial muscles and opens up the airway of a patient and allows to be more comfortable at end of life. For pain control at end of life i prefer it given SL.
  6. by   AtlantaRN
    I've had a patient use it with a lung cancer diagnosis. We had a special nebulizer set up especially for the morphine neb. The good thing was, if he was extremely short of breath, he would only need an inhallation or two and his anxiety would ease right off. Granted, I don't know if it was actual absorbtion or if it was "telling him" it would ease right off. Either way, it worked for him.

    linda

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