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Morphine IR from the ED


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Hi all. I was recently listening to an emrap podcast on analgesics. I am very wary of prescribing narcotics in general and a suggestion was made that instead of prescribing norco/oxy (due to their euphoric effects -- which underlies the abuse potential), to prescribe morphine IR tabs (no euphoria and you can rx good ole Tylenol as well) instead. I wanted to get your thoughts and see if any of you have ever done/do this. I've only ever seen it with cancer pts and none of my collegues have ever done this either. 

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I do RX for it occasionally and I like it for ED analgesia as well. At my old shop, one of the docs was a Pharm/MD and she was a huge proponent of this. She basically sold me on it for the same reasons - helps with pain, but no euphoria. I haven't looked it up myself, but she further stated the opiod user message boards said the same thing, good for pain, bad for highs. Anecdotally, I've experience similar results. Also, it's not a tylenol combination and it avoids straight oxy/roxy/etc, so it also wins in that department as well. This MD was also running a study of giving treating pain with Morphine IR in a supervised holding area where patients would sit/lay while waiting for a room on one of the teams after being assessed (busy place with lots of sick people). It was working well with no major adverse events that I heard ofgma and I am looking forward to seeing it published.

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