A patient with end-stage lung disease may develop significant dyspnea which can physical impairment and impact the patient's quality of life.
Patient selection: severe dyspnea that persists despite correction of any contributory factors (anemia, etc)
Dose: 20 mg oral morphine sulphate in the morning as a sustained released formulation
Benefits:
(1) decreased dyspnea
(2) improved sleep
Complications:
(1) nausea and vomiting
(2) sedation (can be modified by using a lower dose or dosing in the evening)
(3) constipation (can be modified by diet, laxatives and methylnaltrexone)
The use of a low dose, sustained release preparation avoids respiratory depression and hypercapnia.
If the oral route is not available, then parenteral morphine can be used.
Alternative opiates include dihydrocodeine and diamorphine.
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Purpose: To determine if a patient with severe dyspnea may benefit from low dose, sustained release oral morphine sulphate.
Specialty: Pulmonology
Objective: selection
ICD-10: J98.4, F45.3,
