April 2006, Volume 36 Number 4 , p 10 - 10
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.