ADVICE P.R.N.: Down with dyspnea

April 2006 
Volume 36  Number 4
Pages 10 - 10
  PDF Version Available!


Last week I cared for a patient with advanced chronic obstructive pulmonary disease. Despite various standard treatments—including supplemental oxygen, bronchodilators, inhaled steroids, and relaxation techniques—he was having a lot of trouble breathing. When he refused to be intubated, his health care provider ordered nebulized morphine, 2 mg every 4 hours, which was titrated upward over the next few days to 10 mg. This relieved my patient's dyspnea significantly. He reported feeling much more comfortable and experienced no adverse reactions from the morphine.

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