morphine

[val234]

if a patient is presecribed 15 mg but is given 30 mg of morphine sulfate IR tablets, would this cause an earlier death in a liver cancer patient?  My aunt was given 8 - 10 months and the pharmacy gave the wrong dosage, she died in 5 days.  Should I question this?

[Mollyrae]

Hi Tuck:

I do agree to some point. The Pharmacys I have used in the past have always explained the dosage, is everything going ok, ect...but your right maybe they did not explain or go over enough with this patient. Of course the elderly have memory issues that might add to an error. My concern was that it was overlooked on both ends. I think that Val has a good case against the Pharmacy, ultimately their at fault. All in all, you have made a good point, thank's.
Molly

[Tuckamore]

The other question I would have was the 15mg of Morphine also to be an IR as was the 30mg that your aunt was given? That would be an even bigger difference.

Just thinking!
Peace, Tuck

[Tuckamore]

Patients rely on their physician and pharmacists to assure they have the correct medication and dosage. Often seniors or very ill individuals do not pay attention to the dose or even the medication when the picking up the prescription. My pharmacy does not often mention the dosage. They will just say, "This is a refill on your B12. Do you have any questions?" ...or... "This is a new prescription. Your doctor wants you to inject this B12 every month. Do you have any questions?"

Patients don't always know what dose they are receiving. It is surprising how many ppl just trust the medical providers to see that everything is correct. My mother never questions the pharmacist or the physician. She just takes what ever is in the bottle. My father is the same. I can certainly understand how the patient just trusted that the medication and dosage was correct. After all they no longer even have the written prescription for comparison.

This is a perfect example of why all ppl should know what the physician has prescribed and what they actually receive from the pharmacist. A patient, especially a terminal one does not always know the dosage they were to receive. The physician probably discussed many things with the patient that day. The medication dosage was probably the least important to the patient. And again how are they to cross reference what the physician ordered if the pharmacy maintains the prescription? In my opinion this error does not rest on the patients shoulders. This is clearly an error of the pharmacy. But that's only my opinion. I am not saying I am right, it's just my opinion.  
Peace, Tuck

[Mollyrae]

Hello Val234:

I'm very sorry to hear of your aunts death. As Tuck mentioned, the increase in meds should not have caused her death. It sounds like she was fraile to begin with.

The Pharmacy made a huge error and should be acted on accordingly but I don't understand is when you recieve the medication, the Pharmacist goes over the drug with you and you should have spoke up at that point. Somebody knew when picking up the medication that the dose was wrong.

I guess it was an error on both ends. I don't mean to sound harsh but that's the reality of it. It is in my opinion that you take action on the Pharmacy where the problem started and then to the person responsible for picking up and giving her the meds.
Take care and again, I am truley sorry for your loss.
Mollyrae

[Tuckamore]

Hi Val,

Welcome to the Pain Management Forum at MedHelp. I am sorry for your loss.

You ask a difficult question. Morphine, like other opiates slow our respirations. 30 mg of Morphine in itself should not have caused you Aunt's death. However if she was extremely frail and on additional medications that caused respiratory depression it could have been a contributing factor.  Many chronic pain patients take even higher doses of Morphine and function.

Morphine has many side effects. The most dangerous is respiratory depression. Minor degrees of respiratory depression may be detected following standard doses of morphine, but this is not clinically important. With higher doses or in frail patients, the respiratory rate decreases, the patient becomes increasingly sedated, and the pupils very small. One can stop breathing if the respirtory depression is great enough.

The pharmacy made an error. They doubled the dose that the physician prescribed. I would certainly make a written complaint, if you haven't already done so. I assume the physician also knows of the error. If not I would be certain to notify him. Only an autopsy could prove the actual cause of her death and than even those can be inconclusive.  

I assume your aunt was at home and administered the medication to herself. If not there may be other liabilities. Nothing will bring you Aunt back, I'm very sorry for that. But when errors are made it should be noted so it does not happen again. When a plumber makes an error, your facet may still leak. When Medical providers may an mistake it is much more serious.
Good luck to you. Peace, Tuck

[addict7]

too much morphine can result in death. I would advise you to call your pharmacist for information - they would be able to give you pharmaceutical information that would clarify this situation.
I am sorry for you loss and the experience around it.
Deanna