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