Breakthrough or Rescue Doses of Morphine
  • A breakthrough or rescue dose (used interchangeably in the literature) of morphine is one that is given when the patient requires morphine for symptoms in addition to the regularly prescribed dose
  • It is used to treat episodic or breakthrough pain which has several types:
  • Spontaneous pain (unrelated to movement or other incident)
  • Incident pain (related to an activity, action or event)
  • End-of-dose pain (occurring just prior to the next scheduled dose)
  • It is made available on a prn basis in addition to their regular dose
  • Providing a breakthrough or rescue dose of morphine is an important part of managing pain, dyspnea and cough
  • Breakthrough or rescuedoses are generally approximately 10% of the total 24 hour dose and should be ordered q1h prn (on an as needed basis)

Example 1: A patient receives 10 mg q4h SC of morphine = 60 mg in 24h SC. Therefore, appropriate breakthrough or rescue dose is 5 mg q1h prn SC
Example 2: A patient receives 5 mg q4h PO of morphine = 30 mg in 24h PO. Therefore, appropriate breakthrough or rescue dose is 2.5 mg q1h prn PO

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