Continue typing to refine. Marketing authorisation number s 9. Morphine salts are sensitive to changes in pH and morphine is liable to be precipitated out of solution in an alkaline environment. Not all types of medication can be used in a subcutaneous infusion. Subcutaneous infusion solution should be monitored regularly both to check for precipitation and discolouration and to ensure that the infusion is running at the correct rate.

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The number of drugs should be as few as possible, for even the taking of medicine may be an effort.

Midazolam Subcutaneous infusion solution should be monitored dyringe both to check for precipitation and discolouration and to ensure that the infusion is running at the correct rate.

If non-opioid analgesics alone are not sufficient, then an opioid analgesic alone or in combination with a non-opioid analgesic at an adequate dosage, may be helpful in the control of moderate pain. R K Parker et al Jama v.

Prescribing in palliative care | Medicines guidance | BNF content published by NICE

There are no pre-clinical data of relevance to the prescriber which are additional to that already included in other sections of the SPC. Mather studied and produced the following pharmacokinetic data for parenteral morphine.

Vitamin K may be useful for the treatment and prevention of bleeding associated with prolonged clotting in liver disease. Anorexia Anorexia may be helped by prednisolone or dexamethasone. Promethazine hydrochloride – cloudiness was reported to develop when 2.

Morphine Sulfate Injection BP 2mg/ml

Other side effects include slow heart beat, palpitations, cold sensation, restlessness and mood changes. Dexamethasonespecial care is needed to avoid precipitation of dexamethasone when preparing it.


Glycopyrronium bromide may also be used to treat bowel colic or excessive respiratory secretions. It acts mainly on the central nervous system and smooth muscle. An antiemetic syrinve usually necessary only for the first 4 or 5 days and therefore combined preparations containing an opioid with an antiemetic are not recommended because they lead to unnecessary antiemetic therapy and associated side-effects when used long-term.

In theory injections dissolved in water shringe injections are more likely to be associated with pain possibly owing to their hypotonicity. A suitable laxative should be prescribed routinely. Ketamine is sometimes used under specialist supervision for neuropathic pain that responds poorly to opioid analgesics.

Morphine Sulfate Injection BP 2mg/ml – Summary of Product Characteristics (SmPC) – (eMC)

Parenteral route The equivalent parenteral dose of morphine subcutaneous, intramuscular, or intravenous is about half of the oral dose.

An additional dose should also be given 30 minutes before an activity that causes pain, such as wound dressing. In the case of obstructive jaundice, further measures include administration of colestyramine.

Dry mouth Dry mouth may be relieved by good mouth care and measures such as chewing sugar-free gum, sucking ice or pineapple chunks, or the use of artificial saliva ,dry mouth associated with candidiasis can be treated by oral preparations of nystatin or miconazolealternatively, fluconazole can be given by mouth.

Thereafter, the dose should be adjusted with careful assessment of the pain, and the use of adjuvant analgesics should also be considered. Ideally, the cause should be determined before treatment with an antiemetic is started. Although drugs can usually be administered by mouth to control the symptoms of advanced cancer, the parenteral route may sometimes be necessary.

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Constipation is a common cause of distress and is almost invariable after administration of an opioid analgesic. When prescribing this medicine, patients should be told: To minimise the risk of infection no individual subcutaneous infusion solution should be used for longer than 24 hours. Patients with advanced cancer may not sleep because of discomfort, cramps, night sweats, joint stiffness, or fear.

Not for multidose use. Formulations of transdermal patches are available as hourly, hourly and 7-day patches, for further information see buprenorphine. Midazolam is also used for myoclonus. The following hour oral doses of morphine are considered to be approximately equivalent to the buprenorphine and fentanyl patches shown, however when switching due to possible opioid-induced syrjnge, reduce the calculated equivalent dose of the new opioid by one-quarter to one-half.

Drug treatment The number of drugs should be as few as possible, for even the taking of medicine may be an effort. See also Dry mouthabove. Hyoscine butylbromide is used for bowel colic and for ,orphine respiratory secretions, and is less sedative than hyoscine hydrobromide. The family may be reassured by the knowledge eyringe the patient will be admitted to a hospital or hospice if the family cannot cope. Type 1 glass vial with halobutyl rubber stoppers and aluminium overseal.