aerosolized morphine (nebulized morphine)

Indications

• relief of dyspnea in palliative care

* of no benefit; use oral morphine

Dosage

• morphine for injection 10 mg/mL
• 5-20 mg every 3-4 hours PRN Administration:
• nebulizer (e.g. Pulmoaid)
• 3 mL normal saline
• 3 mL syringe with 20 gauge needle & alcohol prep pads
• albuterol &/or ipratropium (Atrovent) may be added to morphine in nebulizer & administered simultaneously

Pharmacokinetics

• bioavailability 10-15%
• loss of drug into atmosphere

Adverse effects

• GI effects should be less than oral form
  • constipation
  • nausea
• fatal respiratory arrest, especially with
  • drug abuse
  • patients with poorly controlled asthma Mechanism:
• unknown
• may be local effects involving afferent nerve pathways

• drug adverse effects of opiates
• drug adverse effects of psychotropic agents
• drug adverse effects of sedatives

More general terms

• morphine
• aerosolized agent