How do you titrate PCA with morphine?

How do you titrate PCA with morphine?

Start dosing: PCA demand dose = 1-3 mg morphine; Delay Interval = 8-10 min. Initial CI (if any) is dependent on the clinical situation. For instance, 1 mg/hour of IV morphine is approximately equivalent to 35 mg bid of oral morphine ER.

What is the basal rate for PCA pump?

Many prescribers routinely selected a 0.5 mg/hour basal infusion, regardless of patient characteristics.

How do you calculate basal morphine?

Example: a patient on oral extended release morphine 60 mg q12, now unable to swallow. 60 mg q 12 = 120 mg/24 hours PO morphine = 40 mg IV morphine/24 hours = approximately 2 mg/hr IV infusion basal rate). Second, if the current opioid dose is not effective, dose escalate the basal dose by 25-100% (see Fast Fact #20).

What is a basal PCA?

Basal rate: Basal rate is the amount of drug given as a continuous infusion and is set per hour. For example ‘morphine 2 mg per hour’. Basal rate is useful in opioid tolerant patients, patients with severe rest pain and for nighttime analgesia. Obviously monitoring is essential to detect respiratory depression.

How does PCA dosing work?

The PCA pump contains your pain medicine. Usually that medicine is morphine, but other painkilling drugs are sometimes used. The pump is connected through a tube to a vein in your body. You press a button when you feel pain and the pump gives you a dose of medicine set by your doctor.

What is a basal rate in diabetes?

Basal rate defined As it applies to diabetes, the basal rate is the rate at which an insulin pump infuses small, “background” doses of short-acting insulin. Over a 24-hour period, the basal flow of insulin accounts for about 50% of a person’s total daily insulin requirement.

Can a PCA cut nails?

T Do not cut fingernails or toenails.

How much is a bolus of morphine?

Morphine is usually used in PCA with a bolus dose of 1 mg and a lockout interval of 5-10 minutes. Hence patients may use up to 12 mg in one hour.

Can you overdose on PCA pump?

However, one of our patients experienced respiratory depression and hypotension within 30 minutes of initiation of PCA therapy. We discovered that machine malfunction caused continuous activation of the PCA button, resulting in a drug overdose.

Is PCA is a high risk procedure?

Risks of PCA. PCA is safe and effective. The main risk is having a reaction to the opioid medicine.

Can you overdose on a morphine pump?

Receiving too much morphine – through your pump or in combination with oral medications or patches – can cause an overdose and lead to serious breathing problems or possibly death. Too little morphine can lead to symptoms of withdrawal.

How do you calculate basal rate?

Calculate Basal Metabolic Rate Your basal metabolism rate is produced through the following basal metablic rate formula: Men: BMR = 88.362 + (13.397 x weight in kg) + (4.799 x height in cm) – (5.677 x age in years) Women: BMR = 447.593 + (9.247 x weight in kg) + (3.098 x height in cm) – (4.330 x age in years)

What was the basal dose of hydro morphone PCA?

Upon arrival to the inpatient unit, she was started on HYDRO morphone PCA (patient controlled analgesia), which included a basal infusion of 0.5 mg per hour, a demand dose of 0.2 mg with a lockout interval of 10 minutes, and a 4 hour limit of 6 mg. Continuous pulse oximetry was not in use. Five hours later, the patient was found unresponsive.

How often should you take morphine with PCA?

Loading Dose:PCA should be initiated after an initial bolus dose of morphine 5 – 20 mg (2-3 mg every 5 minutes up to 20 mg) to attain adequate plasma morphine concentrations. Doses should be reduced in patients over 70 years, and in patients with severely compromised physical status. PCA Dosing:Morphine is the drug of choice.

What is the basal infusion rate for PCA?

Basal/Continuous Infusion Rate: This may be necessary for severe pain, opioid tolerant patients, or those patients who are unable to activate the PCA button. Usual starting infusion rate would be morphine 1 –2 mg/hr, Fentanyl 10- 25 mcg/hr, Hydromorphone 0.1 – 0.3 mg/hr, Meperidine 10 mg/hr.

What should be the dose of PCA in an adult?

Guidelines for Adult Patients Intravenous PCA Orders Loading Dose: PCA should be initiated after an initial bolus dose of morphine 5 – 20 mg (2-3 mg every 5 minutes up to 20 mg) to attain adequate plasma morphine concentrations. Doses should be reduced in patients over 70 years, and in patients with severely compromised physical status.