Published
Fentanyl would work as well or better in a MI patient. This is especially true in the setting of RVI where the histamine release associated with morphine could be problematic. We are also anticipating a vecuronium shortage. My employer is stocking up on rocuronium to ensure we have access to a NDNMB.
We had a Nubain shortage last year on our L&D unit. Apparently the company stopped making it and we were using demerol in it place. That is until all our pregnant patients starting vomiting all the time after the Demerol. Wasn't long before the company was flooded with complaints like this and began producing the Nubain again!
It is the 2mg/mL doses that are part of the shortage.....there is still plenty of the 10mg/mL.
Some facilities just use 5 or 10mg vials. I spoke to a couple of Pharmacists about that, and they explained that there is very little price difference in the cost of 2mg vs 10mg....that morphine the drug is cheap, but that it is the handling/packaging/legal paperwork that jacks up the price. Thus wasting is not that much of a financial waste.
When I worked hospice with MS Contin...the 30mg tabs cost was within pennies of the cost of the 100mg. We would have patients using 60mg (2 - 30s)and eventially they would need to step up the dose...the MD would write for 90mg (3 - 30s). We got them to switch from 90mg to 100mg.... because at that level, there is not much difference in effect but it dropped the charges alot, as well as allowed them to swallow one pill instead of 3.
Lunah, MSN, RN
14 Articles; 13,773 Posts
Anyone else seeing this? We've been told that morphine is on national backorder until October. I guess it'll be tough for MONA to greet everyone at the door for a while. Heh.