kmfr
Member
Reged: 08/09/03
Posts: 104
Loc: US
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For condensed oral solutions like liquid morphine and liquid lorazepam, is the normal administration to place the drops under your toungue and hold them there or to just drip them on your toungue and swallow? Also, are the usually scented? Thanks.
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Take care and be safe.
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potatoboy99
Permanent Fixture
Reged: 02/04/03
Posts: 1200
Loc: Deep North (East)
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Quote:
Also, are the usually scented? Thanks.
Scented like in Lemony Fresh? Sorry, I couldn't resist. I have no personal experience with liquid morphine, but a number of meds, such as the oral version of buprenorphine are recommended as administered "sublingually", meaning under the toungue. Good delivery system, straight to the bloodstream, if you swallow you end up with the morphine in the digestive tract. Somebody correct me if I'm wrong.
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Opie_Yates
Old Hand
Reged: 08/11/03
Posts: 470
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I prefer the Flinstones chewable morphine.
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I'm not a doctor, I just play one on a message forum!
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sensorium
Board Addict
Reged: 12/12/01
Posts: 386
Loc: US
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LOL....
I am "pretty" sure those drugs are in liquid form as an injectable solution, not sublingual delivery.............
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guitardude
Old Hand
Reged: 09/11/02
Posts: 421
Loc: midwest
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no, actually I think they do make a liquid morphine to be takin sl. I think it's for cancer patients that are to sick to take pills. I saw this in a movie, so I might be wrong. I know my grandfather was a pharmacist when I was in high school, and he had a huge bottle of liquid codeine in his cabinet.( of course until I, being the oldest and most experimental of the kids, found it)
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"once in a while you can get shown the light, in the strangest of places if you look at it right."
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night_shade
Threadhead
Reged: 08/26/03
Posts: 907
Loc: The State of Hockey
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I used to take the 20mg/ml MSIR. I was instructed to dilute it with juice or water and drink it. I preferred this method as the taste was horrible. Same instructions for 10mg/ml methadone same horrible taste and both were clear liquids (both made by Roxane when I was on it--wasn't much difference in taste between the 2.) No alcohol in either one.
I was cautioned to keep the Roxanol bottle in a ziploc bag as it could be absorbed through the skin.
I noticed some numbing effect to the tongue and throat if taken in concentrate without water.
I didn't notice any difference in absorbtion time between using it without water or with water. Honestly, it is FAR more palatable with water and swallowed.
I never was told to or thought of using it sublingually.
Hope this is helpful!
night_shade
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Never underestimate the predictability of stupidity.
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prettyday
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Reged: 02/09/03
Posts: 924
Loc: Coastal Sage Scrub
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Yes, this is how the VA gave morphine to my dad- orally in a disposable cup.
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First they ignore you, then they laugh at you, then they fight you, then you win.
- Mahatma Gandhi
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Sky_Queen
Fly Girl
Reged: 12/03/02
Posts: 1962
Loc: Texas
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You're right. My husband's grandmother was dying in hospice and all of her pain meds were given with a dropper under her tongue in addition to a patch - they try not to use IV's in hospice unless they have to.
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kmfr
Member
Reged: 08/09/03
Posts: 104
Loc: US
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Thanks to those of you who had helpful replies. Yes it is the 2omg/ml generic Roxanol, so I'm sure the dropper is for oral use (not injectible.) I just wasn't sure what was the propper method of delivery (sublingual or to just swallow.) Niether my doctor nor my pharmacist answered the question. Thanks.
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Take care and be safe.
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rblake
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Reged: 06/02/03
Posts: 20
Loc: USA
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Quote:
I just wasn't sure what was the propper method of delivery (sublingual or to just swallow.) Niether my doctor nor my pharmacist answered the question.
I worked as a pharmacy tech for several years during the 90's, and my boss, the pharmacist who owned the store, went out of his way to make certain that directions--especially those for all C-II and certain other medications--were clearly and fully understood when the patient picked up his or her medicaton. Whatever directions were written by the prescribing physician following the "Sig:" on the precscription form should be followed.
I am really surprised to read that neither the prescribing physician nor the pharmacist filling the prescription would clarify such an important question! In my state, a "pharmacy consult" is required by law. I do not recall whether such a consult is mandated for every prescription, but it certainly is for any C-II medication when it is dispensed.
One of the previous posts (Potato's, I think) is right on the mark: when morphine is swollowed, some of it is destroyed in the stomach before it can be absorbed into the blood. I believe this fact is a primary reason why in hospital settings, for example, morphine is most often given by injection even to patients who are alert and able to swallow tablets or capsules.
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"... A little learning is a dangerous thing; drink deep, or taste not the Pierian spring...."
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kmfr
Member
Reged: 08/09/03
Posts: 104
Loc: US
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I was suprised as well, each told me to refer to the others instructions. I believe it is something like 60-90% of morphine is metablized during the first pass before reaching the target site, I just wasn't sure if holding the liquid under my toungue for a bit would help. I think maybe that is why it is lightly scented, but it still tastes bad.
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Take care and be safe.
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night_shade
Threadhead
Reged: 08/26/03
Posts: 907
Loc: The State of Hockey
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Hello again...just an aside. I don't remember there being any specific scent (i.e. orange or cherry) and as it was a clear liquid, but I definitely remember the sourish slash ear wax taste of it! I know that some companies started putting dyes and flavoring to help reduce illicit IV use by some of these meds--although I believe the techical explanation was to make it easier to "see" when measuring the doses. At one time I was also on the 10mg/5ml MSIR and it was blue (no taste difference though!)
I tried the sublingual method for this morning's methadone and it was FAST, FAST, FAST! Wow--it usually takes an hour to "activate."
Good luck!!!!
night_shade
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Never underestimate the predictability of stupidity.
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kmfr
Member
Reged: 08/09/03
Posts: 104
Loc: US
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Yes, the morphine is bluish dyed and smells faintly of vanilla, where the lorazepam is clear and smells strongly of mint.
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Take care and be safe.
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Jeremiah
Agape GrandParent
Reged: 07/14/02
Posts: 705
Loc: U.S.A.
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When I was getting discharged from the Hospital in August, waiting for the paperwork in my room, the Nurse ask and brought me some liguid morphine in a cup to drink. (my IV had been dc'd)It was clear liquid,maybe a slight tint of yellow and it tasted awful! Left a somewhat bitter after taste.I don't care for this stuff at all,but I was thankful she offered as I had a long car ride home and it was time for my next dose.
I can understand why it would need to be flavored.
J.
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I can't see me lovin nobody but you,for all my life
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night_shade
Threadhead
Reged: 08/26/03
Posts: 907
Loc: The State of Hockey
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My methadone (I've taken it in various forms--tablets/liquid/diskette throughtout the past several years) in liquid form has been changed according to pharmacy cost, availability, etc... Originally it was the clear 10mgs/ml Roxane brand, then went to a generic in a cherry "flavor" (same strength) and pinky color. Now it's orange flavored (has alcohol in it now, too--the others did not.) No matter what flavor or lack thereof, it still tastes nasty. The worst, by far, has been the newest stuff in the orange flavor with alcohol (made by Roxane 5mgs/5ml.) Do they even taste test this stuff??? It's simply gross and the cherry or orange flavors make no difference in its palatability. I've always wondered if they don't make it taste too good in case a child got ahold of it or something like that.
Who knows????
night_shade
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Never underestimate the predictability of stupidity.
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rblake
Stranger
Reged: 06/02/03
Posts: 20
Loc: USA
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Quote:
No matter what flavor or lack thereof, it still tastes nasty. The worst, by far, has been the newest stuff in the orange flavor with alcohol (made by Roxane 5mgs/5ml.) Do they even taste test this stuff??? It's simply gross and the cherry or orange flavors make no difference in its palatability. I've always wondered if they don't make it taste too good in case a child got ahold of it or something like that.
Taste testing? That's an interesting thought! I would imagine that several pharmaceutical companies would have lines of potential taste testers extending for blocks. Roxane and Purdue would certainly be among those companies. I wonder how many would volunteer to taste test, for example, the new OxyContin that Purdue is designing so that chewing the tablet does not destroy its SR properties? Please note: the previous remarks were NOT intended to hurt the feelings of or make fun of ANYONE who genuinely needs these drugs in whatever dose it takes to ease his or her suffering! Diacetylmorphine (heroin) is legally available in the United Kingdom so that physicians can prescribe it to those may need it. According to a number of studies it is a superior analgesic to morphine and hydromorphone (Dilaudid). I've never looked for or seen any studies comparing heroin with fentanyl (Duragesic, etc.)
In my opinion most drugs taste bad. Some of them have a terrible taste! When I was a child, I contracted strep throat. I came very close to having rheumatic fever. On discharge from the hospital, I was placed on penicillin tablets for several months, and I had to take a tablet several times each day. When all this happened penecillin was available only in tablet and injectable form, i.e., no suspension or liquid was yet on the market. Moreover, the tablets were not yet coated. About a week into my several month's course of treatment, the taste had become so repulsive that I felt like vomiting after each dose. Actually, I did throw up a few times. (Remember: I was a little kid.) My mother came up with the idea of breaking the tablet into a couple of pieces and putting them in a tablespoon of honey. Her idea worked; however, I was still able to taste the penicillin to some extent. Bottom line: for YEARS I could not stand to eat honey in any form on anything because I literally could taste penicillin even though none was present.
Final thought: IMHO flavoring or lack of flavoring is probably of little concern to the pharmaceutical companies in terms of discouraging a curious child. I'm sure everyone of us has read or heard the tragic stories of children who drink laundry bleach or swallow other household chemicals/medications. Bleach--even its odor--is certainly more repulsive than any medication with which I'm familair.
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"... A little learning is a dangerous thing; drink deep, or taste not the Pierian spring...."
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