Morphine 2mg carpuject, duramorph

[Oggg]

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So we have a national shortage of duramorph, a preservative free morphine. My pharmacy says that the little 2mg/1cc morphine carpujects are also preservative free. Does anyone know of a reason why we can't use the carpujects for intrathecal or epidural injection?

 

[deleted126335]

So we have a national shortage of duramorph, a preservative free morphine. My pharmacy says that the little 2mg/1cc morphine carpujects are also preservative free. Does anyone know of a reason why we can't use the carpujects for intrathecal or epidural injection?

I'd check the package insert to be sure.

 

[IlDestriero]

Yeah, as long as it's preservative free, you're good to go. We have both 1mg/ml and 0.5 mg/ml preservative free.

 

[Oggg]

Yeah we had two vials of duramorph/astromorph. One was 5mg/10cc, the other was 10mg/10ml. Our standard dose is 0.2mg IT or 2mg EPID, so we were ALWAYS wasting 60-90% of a vial each time. The 2mg/1cc morphine carpuject is confirmed to be preservative free. If we can use the carpuject, we'll cut down a ton on waste. We wouldn't ever need the duramorph anymore except for the dinosaur orthopods who inject 10mg into a joint.

 

[cchoukal]

Do the carpujecte have a rubber stopper? Is that a reason not to use them?

 

[rsgillmd]

Do the carpujecte have a rubber stopper? Is that a reason not to use them?

I think they do -- but I'm not definite because I could be mistaken about the brand here.

Either way, rubber stopper shouldn't matter -- just use a filter needle. It's just annoying going through a rubber stopper when sterile. When we had a shortage of fentanyl ampules, but it was available in vials, we drew up the fentanyl and injected it into a pocket in the epidural tray before putting on sterile gloves.

I always use a filter needle when drawing up meds to be given intrathecally or epidurally. The only thing that should matter would be the presence of a preservative.

 

[urge]

Want to hear a messed up story regarding duramorph?

I have met "professors" who pontificate that the left over duramorph after neuroaxial cannot be given iv because "it lasts many many hours". The would actually open a regular iv morphine and waste the duramorph.

There must be something special in the preservatives they use to cut its half life.

 

[IlDestriero]

Want to hear a messed up story regarding duramorph?

I have met "professors" who pontificate that the left over duramorph after neuroaxial cannot be given iv because "it lasts many many hours". The would actually open a regular iv morphine and waste the duramorph.

There must be something special in the preservatives they use to cut its half life.

Wow, that's stupid.

 

[Oggg]

Wow

 

[Oggg]

Ok the head pharmacist says the 2mg/1cc morphine carpuject has EDTA, so it's preservative free but not neurotoxin free