using the table below. But before using the table we must determine their morphine usage, so what is this patient's total daily dosage of IV morphine?

Phlebotomy Essentials
6th Edition
ISBN:9781451194524
Author:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Publisher:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Chapter1: Phlebotomy: Past And Present And The Healthcare Setting
Section: Chapter Questions
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A patient is receiving morphine sulfate intravenously via a patient controlled analgesia (PCA) pump. The
concentration of the solution is 11 mg/mL and is being infused continuously around the clock at a rate of 0.1
mL/hr. The patient may also access a 2-mg bolus dose every hour for breakthrough pain if needed and they
are currently using an average of 5 additional bolus doses per day. The patient is to be converted to fentanyl
using the table below. But before using the table we must determine their morphine usage, so what is this
patient's total daily dosage of IV morphine?
TABLE 10.3 FENTANYL TRANSDERMAL DOSAGE CONVERSION GUIDELINES", b
Current Analgesic
Oral morphine
IM/IV morphine
Oral oxycodone
Oral codeine
Oral hydromorphone
IV hydromorphone
IM meperidine
Oral methadone
60-134
10-22
30-67
150-447
8-17
1.5-3.4
75-165
20-44
Recommended fentanyl transdermal system dose
Fentanyl transdermal system
25 mcg/h
Daily Dosage (mg/day)
135-224
23-37
67.5-112
17.1-28
3.5-5.6
166-278
45-74
225-314
38-52
112.5-157
28.1-39
5.7-7.9
279-390
75-104
315-404
53-67
157.5-202
75 mcg/h
39.1-51
8-10
391-503
105-134
50 mcg/h
"Adapted from Lexicomp Lexi-Drugs [book online]. Baltimore, MD: Wolters Kluwer Clinical Drug Information; 2020.
b
This table should not be used to convert fentanyl transdermal to other therapies because the conversion to fentanyl transdermal is conservative. Use of this table for conversion to other analgesic
therapies can overestimate the dose of the new agent. Overdosage of the new analgesic agent is possible.
100 mcg/h
Transcribed Image Text:A patient is receiving morphine sulfate intravenously via a patient controlled analgesia (PCA) pump. The concentration of the solution is 11 mg/mL and is being infused continuously around the clock at a rate of 0.1 mL/hr. The patient may also access a 2-mg bolus dose every hour for breakthrough pain if needed and they are currently using an average of 5 additional bolus doses per day. The patient is to be converted to fentanyl using the table below. But before using the table we must determine their morphine usage, so what is this patient's total daily dosage of IV morphine? TABLE 10.3 FENTANYL TRANSDERMAL DOSAGE CONVERSION GUIDELINES", b Current Analgesic Oral morphine IM/IV morphine Oral oxycodone Oral codeine Oral hydromorphone IV hydromorphone IM meperidine Oral methadone 60-134 10-22 30-67 150-447 8-17 1.5-3.4 75-165 20-44 Recommended fentanyl transdermal system dose Fentanyl transdermal system 25 mcg/h Daily Dosage (mg/day) 135-224 23-37 67.5-112 17.1-28 3.5-5.6 166-278 45-74 225-314 38-52 112.5-157 28.1-39 5.7-7.9 279-390 75-104 315-404 53-67 157.5-202 75 mcg/h 39.1-51 8-10 391-503 105-134 50 mcg/h "Adapted from Lexicomp Lexi-Drugs [book online]. Baltimore, MD: Wolters Kluwer Clinical Drug Information; 2020. b This table should not be used to convert fentanyl transdermal to other therapies because the conversion to fentanyl transdermal is conservative. Use of this table for conversion to other analgesic therapies can overestimate the dose of the new agent. Overdosage of the new analgesic agent is possible. 100 mcg/h
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