Week 2 (January 18 & 20)
Lab/Discussion - Quiz #1

Suppose the patient in one of yuor cases was to be switched to continuous infusion morphine as opposed to transdermal fentanyl. The patient had been receiving oral morphine immediate release 30 mg every 4 hours.

1. What route of administration would you choose for continuous infusion?

Answer: intravenous, although subcutaneous will be acceptable

 

2. What dose would you recommend to start? Remember, doses for continuous infusion should be expressed as a rate?

Answer: 3 mg/hr

 

3. In the event that parenteral morphine was temporarily unavailable at your pharmacy, which would you recommend instead: hydrommorphone or meperidine?

Answer: Hydromorphone

 

The patient has been taking morphine for six months. He complains of constipation, but it is relieved with regular doses of milk of magnesia. His respirations are 16 per minute.

4. Which of the following statements is accurate?

a. Milk of magnesia has promoted the development of tolerance to the constipating effect of morphine, but the respiratory rate indicated physical dependence.

b. Tolerance has developed to the respiratory depressant effect of morphine, but continued complaints of constipation indicate drug-seeking behavior.

c. Tolerance has not developed to the constipating effect of morphine, but tolerance has developed to the respiratory depressant effect.

Answer: c. Tolerance has not developed to the constipating effect of morphine, but tolerance has developed to the respiratory depressant effect.