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Many health care professionals and members of the community are
reluctant to use morphine and other narcotics because of widespread
myths and misconceptions about their effects. The following are
some of the most common myths about the use of morphine to treat pain
in the terminally ill patient:
Morphine = respiratory depression
Clinically significant respiratory depression is extremely rare in
patients who receive optimized doses of morphine. When morphine
is carefully titrated, it is a safe analgesic even in patients with
respiratory disease. In fact, low doses of morphine are
effective in the management of increasing dyspnea.
Morphine = addiction
Addiction does not occur when morphine is administered reqularly at
individually optimized doses in the patient experiencing pain.
Morphine = euphoria
The use of morphine does not produce euphoria in the terminally ill
patient. Mood may improve because of pain relief and the ability
to sleep and eat.
Morphine = narrow effective drug range
Morphine has a very wide effective dose range. Two mg every four
hours may be an effective dose for some patients while 300 + mg every
four hours may be an effective dose for others.
Problems with Morphine
- Drowsiness - Wear off
- Nausea - 30% Experience
- Constipation - Very Common
- Tolerance - Rare
- Addiction - Extremely Rare
- Acute Urinary Retention
- Opiate Intoxication - Do not follow the PDR recommendations for
use of Narcan.
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