Transcription of Opioid Infusion Guidelines for Palliative Care - ASPMN
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Opioid Infusion Guidelines for Palliative Care - ASPMN
1 Opioid Infusion Guidelines for Palliative CareLeslie N. Schechter, Pharmacy SpecialistBarbara Lineham, RN, MSNM edical/Pain Clinical Nurse SpecialistThomas Jefferson University HospitalPhiladelphia, PennsylvaniaGoal of Opioid Infusion GuidelinesEstablish a step by step approach to rational Opioid Infusion prescribingRecognize that an order to start a Morphine Infusion at 1mg/hour and titrate to effect is pharmacologically unsound and unsafe2 Morphine 1 mg/hr and titrate. Why is this inappropriate?This order places full responsibility for dose titration upon the provides no guidance regarding what dose to titrate or dose titration poses the potential for over dosage by too zealous dose escalationProvides only one option for poorly controlled pain increasing the state drug levels are not being achieved with frequent Infusion rate Dosing Method--ExampleBegin Infusion at 2 mg/hr and give morphine 2 mg q15min for breakthrough pain.
6 Opioid Tolerant Patient MD calculates the 24 hour dose of the currently used opioid (conversion table) Convert to an equianalgesic dose IV morphine and divide by 24 to calculate
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