Method for Administration of Parenteral Morphine for Severe Cancer Pain

Purpose: To develop a dosing plan using parenteral morphine to control severe cancer pain based on the protocol of Nelson et al.

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Evaluation

Are you evaluating a patient with severe cancer pain who is a candidate for parenteral morphine therapy?

Yes

Equivalent dose of oral morphine in mg per day for current oral around the clock pain medication

mg per day

Equivalent dose of oral morphine in mg per day for current oral rescue pain medication

mg per day

Equivalent dose of parenteral morphine in mg per day for current parenteral around the clock pain medication

mg per day

Equivalent dose of parenteral morphine in mg per day for current parenteral rescue pain medication

mg per day

Does the patient have severe pain now?

Yes

Results

Please fill out required fields.

Results Interpretation and Description References Next Steps

Data complete?

Evaluation appropriate?

Total 24 hour parenteral morphine dose equivalent

Hourly dose of parenteral morphine

Rescue dose of parenteral morphine

Initial bolus of parenteral morphine to give by infusion

Initial hourly rate of parenteral morphine to give until pain is under control

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Interpretation and Description

References

Next Steps in Evaluation

Diagnosis

Risk Factors
Clinical Diagnosis, Including Family History For Genetics
- Features Suggestive of Drug Seeking Behavior in Patient
- Clinical Criteria of Chabal et al for Prescription Opiate Abuse in a Patient with Chronic Pain
Severity, Prognosis, Stage
- Clinical Criteria of Chabal et al for Prescription Opiate Abuse in a Patient with Chronic Pain

Therapy

Options
- Management of Pain Associated with Diabetic Peripheral Neuropathy
- World Health Organization (WHO) Analgesic Ladder
Selection
- Contraindications for Use of Fentanyl Transdermal Patch in Patient with Pain
- Risk Factors for Opioid Misuse in Patient with Chronic Pain
Dosage Calculations
- Management of Pain Associated with Diabetic Peripheral Neuropathy
Administration
- Management of Pain Associated with Diabetic Peripheral Neuropathy
- Indications for Using Parenteral Morphine for Control of Severe Pain
Prevention
- Risk Factors for Fentanyl Toxicity in Patient Treated with Transdermal Patch
- Management of Pain Associated with Diabetic Peripheral Neuropathy

Monitoring

Response To Therapy
- Management of Pain Associated with Diabetic Peripheral Neuropathy
- Indications for Using Parenteral Morphine for Control of Severe Pain
Adverse Effects
- Opioid Induced Hyperalgesia (OIH)
Compliance/adherence
- Prescription Opioid Misuse Index (POMI)

Patient Concerns

Quality Of Life
- Management of Pain Associated with Diabetic Peripheral Neuropathy

Specialty

Pharmacology, clinical

Objective

selection
administration

ICD-10

T40.2 - Poisoning, other opioids
F11 - Mental and behavioural disorders due to use of opioids

Info

Purpose: To develop a dosing plan using parenteral morphine to control severe cancer pain based on the protocol of Nelson et al.

Specialty: Pharmacology, clinical

Objective: selection, administration

ICD-10: T40.2, F11,

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