PAIN MANAGEMENT 1 MORPHINE AN OPIOID ANALGESIC

1

PRACTICAL THERAPEUTICS

Morphine sulphate for intravenous or intramuscular use comes as clear liquid in glass ampoules.


You are the FY1 on night ward cover. You see a man with metastatic cancer who was admitted yesterday for urgent radiotherapy who is in severe pain having fallen out of bed.

He is currently written up for modified release morphine sulphate tablets 60 mg b.d. (twice daily) and paracetamol 1g q.d.s (six hourly).

Mutliple Choice Question

Only the following are available on the ward, which one do you choose?

Mutliple Choice Question

Apart from suspension for injection what other preparationsofmorphine sulphateare commonly used in hospital?


Is paracetamol not a weak analgesic?

Opioids and paracetamol have a substantially greater effect when given in combination that a dose of either alone. Paracetamol should not be considered "weak" but as one pillar supporting safe and effective pain relief. Remember they have different mechanisms of action.  


Open Question

There is only one staff nurse on the ward (This can happen if there are staff shortages)  so he asks you to count out the drug and sign for it with him.Why is this legally necessary?

Open Question

The single nurse says that he has not done the Intravenous drug administration course at the hospital you are working for.

What are your options?

Mutliple Choice Question

Having drawn up 1ml of the drug what is the dose/amount of morphine in mg per 1ml in the (full) 10ml syringe you are holding?