Morphine Recommendation

Morphine Recommendation

Correct answer: MSContin 240 mg Q12 hours with MSIR 40 mg q2-4 hours prn breakthrough pain.

Calculation:

1. Total IV Morphine use 18 hours = 85 mg, equivalent to about 115 mg for 24 hour period.
2. IV: PO ratio is 1:3, so 115 mg IV is about 345 mg PO over 24 hours
3. MS Contin 60 mg Q12 was continued while he was on IV Morphine, so total daily dose received was equivalent to about 465 mg or MSContin 240 mg Q12.
4. Appropriate breakthrough dose is about 10% of total 24 hour dose made available every 2-4 hours. So for Mr. M this would be MSIR 40 mg po q2-4 hours prn.

Remember to always prescribe appropriate therapy to ​preventconstipation when writing opiate orders.