Paediatric Palliative Care Guidelines
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Pain - Introduction
Pain Classification
Pain Diagnosis
Pain - Drug management
WHO Pain Guidelines
Initiating morphine
Morphine titration
Managing morphine maintenance
Adverse effects of morphine
Opioid rotation
Alternatives to morphine
Equianalgesic potencies
Golden rules of pain control
Adjuvant pain therapies
Pain Classification
Pain Diagnosis
Pain - Drug management
WHO Pain Guidelines
Initiating morphine
Morphine titration
Managing morphine maintenance
Adverse effects of morphine
Opioid rotation
Alternatives to morphine
Equianalgesic potencies
Golden rules of pain control
Adjuvant pain therapies
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Edition/Revision: 1.0
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Archived
Alternatives to morphine - Archived
- Diamorphine: Similar characteristics to morphine except that it is highly hydrophilic and has increased solubility. This confers a significant clinical advantage in that large doses can be given in small volumes and makes it the drug of choice for IV / SC administration. 1.5 – 2 x as potent as morphine when given by the same route.
- Fentanyl: Highly lipophilic synthetic mu-agonist with around 150 x the potency of morphine. It is wholly synthetic and a different class to morphine, therefore suitable for opioid rotation where adverse effects of opiates have become dose limiting. Available in transdermal, intranasal and parenteral forms. It has a smaller half life than morphine.
- Buprenorphine: Partial mu agonist with mixed agonist and antagonis properties. Available as a sublingual and transdermal formulation (see earlier notes).
- Methadone, hydromorphone and oxycodone are used rarely in children and should be considered only in discussion with the specialist paediatric palliative care team.
Edition/Revision: 1.0
Created 18 Jul 2013 - Archived
Validated 19 Jul 2013 by Ian Back
Last modified 24 Apr 2024
Validated 19 Jul 2013 by Ian Back
Last modified 24 Apr 2024
