Article ; Online: Morphine infusor pump switch to oral methadone.
BMJ supportive & palliative care
2019 Volume 10, Issue 1, Page(s) 1–3
Abstract: Between 2014 and 2017, four patients with widespread cancer were referred to a home palliative care team from a hospital in Oviedo (Spain) with subcutaneous elastomeric infusion pump containing 180-260 mg/day of morphine for previously uncontrolled pain. ...
Abstract | Between 2014 and 2017, four patients with widespread cancer were referred to a home palliative care team from a hospital in Oviedo (Spain) with subcutaneous elastomeric infusion pump containing 180-260 mg/day of morphine for previously uncontrolled pain. 3-4 rotations were performed over 5-11 days, gradually substituting morphine for oral methadone (three times a day) to minimise the risks of rapid conversion, with a highly variable final subcutaneous morphine:oral methadone ratio (5:1 to 17:1), guided by the absence of pain, and to enhance the patient's functional capacity avoiding device dependence. The final methadone dose varied between 15 and 39 mg/day. There was daily telephone supervision and visits every 2-4 days. Patient demise occurred 56, 111, 168 and 350 days following the opioid conversion, and methadone was maintained until then. In all cases and prior to concluding the rotation, pain was controlled and sleepiness had subsided. |
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MeSH term(s) | Administration, Oral ; Aged ; Analgesics, Opioid/administration & dosage ; Cancer Pain/drug therapy ; Dose-Response Relationship, Drug ; Drug Substitution/methods ; Fatal Outcome ; Female ; Humans ; Infusion Pumps ; Infusions, Subcutaneous ; Male ; Methadone/administration & dosage ; Middle Aged ; Morphine/administration & dosage ; Palliative Care/methods ; Spain |
Chemical Substances | Analgesics, Opioid ; Morphine (76I7G6D29C) ; Methadone (UC6VBE7V1Z) |
Language | English |
Publishing date | 2019-04-03 |
Publishing country | England |
Document type | Case Reports ; Journal Article |
ISSN | 2045-4368 |
ISSN (online) | 2045-4368 |
DOI | 10.1136/bmjspcare-2018-001760 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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