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[Oral morphine in the treatment of patients with terminal disease]
J L Manzini1, E J Somoza, H I Fridlender
1Sección de Medicina Paliativa, Hospital Privado de Comunidad, Mar del Plata, Argentina.
Abstract:
From May 1986 until July 1987, oral morphine hydrochloride in water solution was used in terminal patients, under a strict protocol of administration, and complying with the basic principles of Palliative Care. A retrospective study was carried out on the 40 patients who had received the drug for more than three consecutive days. As shown in Table 1, the average age of the treated patients was 70 years. The ambulatory patients represented 27.5% of the sample. The average initial dose was 60 mg, and the average maintenance dose was 120 mg. The median treatment time was 45 days. "Good" results were achieved in 85% of the patients, and "fairly good" in the remainder ("good" results were defined as "satisfactory symptom control, good life quality"--in this group there were some patients who obtained total suppression of the symptoms and optimal life-quality, i.e. "excellent" results; "bad" results were defined as "total absence of therapeutic effect"; and "fairly good" results, the intermediate cases). The more frequently treated symptoms were: 67.5%, pain due to tumor mass; and 20%, pain due to nerve compression-invasion, bone pain, and dyspnoea due to pulmonary metastases or primary lung cancer: total symptoms was more than a hundred per cent, because a number of patients had more than one symptom. Whenever necessary, adjuvant drugs were employed. Side effects were seen in 37% of the patients (specially nausea, vomiting, constipation, and somnolence for more than four days).(ABSTRACT TRUNCATED AT 250 WORDS)