516.291.6118 Desk: 516.663.2921 Fax: 516.663.4644 shanen@winthrop.org [Submitted on: 1/5/2011 by: Suzanne Hanen, RN, GNP-BC, CHPN [SHanen@Winthrop.org]]
175. Morphine as a Bronchodilator? We attempted to trial the fentanyl here. Could not pull it off at this site, over 1000 pt's get it annually. We in fact published how we failed to trial it here in 2009. Hope someone else will. I think there is so much research re neblized morphine no studies will be attempted. Pat [Submitted on: 1/5/2011 by: Patrick Coyne [user479069@aol.com]]
175. Morphine as a Bronchodilator? I have given nebulized morphine. Sometimes it works, despite the studies. Of course morphine sl, po or IV works very well. Karen McGough ARNP ACHPN [Submitted on: 1/5/2011 by: Karen McGough, ARNP, ACHPN [kmcg14@verizon.net]]
175. Morphine as a Bronchodilator? Morphine crosses the blood brain barrier and suppresses the feeling of SOB - although nebulizing morphine has not been proven more effective it is absorbed directly by the membranes and so transported to the Cerebral Cortex and so decreases the perception of dyspnea Investigators are studying the efficacy of nebulized morphine for relief of dyspnea; however, present evidence does not support this route except in extraordinary circumstances. 33-35 While nebulized morphine cannot be recommended as an evidence-based treatment now, it has been considered a promising treatment because it acts locally on opiate receptors in the airways.7 If the opioids are not absorbed systemically, they will not cause the unacceptable side effects that systemic opioids sometimes cause, including somnolence, constipation, and urinary retention.(Spector et al, 2007) I have attached the article for your reading pleasure Regards, Missy (MP) Heylen RN, CHPN [Submitted on: 1/6/2011 by: Missy (MP) Heylen, RN, CHPN [missy_bequia@hotmail.com]]
175. Morphine as a Bronchodilator? The morphine was not administered via nebulizer. If the MOA involves crossing the blood brain barrier, then the route of administration (absent metabolic involvement) should not make any difference except for the speed of uptake. Thanks. Christine A Johnson RN CHPN LMFT