Oral to iv morphine conversion

Initially, inject 5 mg epidurally in the lumbar region and assess the patient in 1 hour; if pain relief is not adequate at that time, administer incremental doses of 1 to 2 mg, with sufficient time between injections to appropriately assess for efficacy. The manufacturer recommends a maximum of 10 mg per 24 hours. For continuous epidural infusion, initiate at 2 to 4 mg per 24 hours, with additional doses of 1 to 2 mg given if pain relief is not initially achieved. The incidence of early and late respiratory depression is dramatically increased with thoracic administration. Use preservative-free formulations only.

Decreased fetal weights were observed in pregnant rats treated with 20 mg/kg/day morphine sulfate ( times the HDD) from Gestation Day 7 to 9. There was no evidence of malformations despite maternal toxicity (10% mortality). In a second rat study, decreased fetal weight and increased incidences of growth retardation were noted at 35 mg/kg/day ( times the HDD) and there was a reduced number of fetuses at 70 mg/kg/day ( times the HDD) when pregnant rats were treated with 10, 35, or 70 mg/kg/day morphine sulfate via continuous infusion from Gestation Day 5 to 20. There was no evidence of fetal malformations or maternal toxicity.

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Monitor patients with significant chronic obstructive pulmonary disease or cor pulmonale , and patients having a substantially decreased respiratory reserve, hypoxia , hypercapnia , or pre-existing respiratory depression for respiratory depression, particularly when initiating therapy and titrating with AVINZA, as in these patients, even usual therapeutic doses of AVINZA may decrease respiratory drive to the point of apnea [see Life-Threatening Respiratory Depression ]. Consider the use of alternative non-opioid analgesics in these patients if possible.

Oral to iv morphine conversion

oral to iv morphine conversion

Monitor patients with significant chronic obstructive pulmonary disease or cor pulmonale , and patients having a substantially decreased respiratory reserve, hypoxia , hypercapnia , or pre-existing respiratory depression for respiratory depression, particularly when initiating therapy and titrating with AVINZA, as in these patients, even usual therapeutic doses of AVINZA may decrease respiratory drive to the point of apnea [see Life-Threatening Respiratory Depression ]. Consider the use of alternative non-opioid analgesics in these patients if possible.

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