hat special prescription requirements will you need from the doctor? Can he prescribe refills over the phone when the patient is unable to get to the clinic? What are the purposes of each excipient in this mixture?
Case Study 1
Morphine Suspension (1 mg/mL)
One of your long-term patients who you have known for many years has progressed to end-stage prostate cancer and been placed on a palliative care program. The currently commercially available morphine liquids he has been using contain a flavouring agent that makes him nauseous. His Physician has requested you compound a morphine liquid for him without flavour as his pain is well controlled on this medication and he does not want to change to another pain reliever. Your pharmacy team and the Physician would like to make his end-of-life process as comfortable as possible. A formulation for a suspension appears to be a good option to try.
RX:
Morphine liquid 1 mg/mL
Sig: Take 1-2 mL q1h prn
Mitte: 100 mL
Formulation:
Morphine HCl 10 mg
Glycerol 1 mL
Compound Hydroxybenzoate Solution 0.1 mL
Purified water to 10 mL
Use within 1 month
Questions:
Calculate the quantities you will require for each ingredient and create a worksheet. (You may make your own lot numbers and expiry dates.)
What special prescription requirements will you need from the doctor?
Can he prescribe refills over the phone when the patient is unable to get to the clinic?
What are the purposes of each excipient in this mixture?
What counselling instructions should you give to the patient for a suspension?
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