INSIGHTS ON DEATH AND DYING: Not just a pain reliever

June 2004 
Volume 34  Number 6
Pages 82 - 82
  PDF Version Available!

© 2004 Lippincott Williams & Wilkins, Inc. Volume 34(6)             June 2004             p 82 Not just a pain reliever [INSIGHTS ON DEATH & DYING: ORAL MORPHINE]


I'm caring for a nursing home resident with end-stage heart failure and pulmonary edema. He's tachypneic at 32 breaths/minute and has a look of terror in his eyes. I called the attending physician and requested small, frequent doses of oral morphine. She refused, saying, “He's not in pain, so morphine isn't indicated.”

I believe a small dose of morphine would make this patient more comfortable and less panicky. Am I wrong? —D.P., TENN.

No, it's the physician who needs a refresher course in Pharmacology 101. Morphine does much more than simply relieve pain. Because it acts as a vasodilator, it can increase cardiac output. It's also a respiratory depressant, ...

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