Mary Lynn McPherson

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498 appearances 2 recordings 1 series first heard Oct 2018 last heard Dec 2021

Mary Lynn McPherson’s voice in public audio — every appearance, attributed to the second.

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And they looked at switching off of methadone to oromorphine and it worked out to be four point seven.

But again, I'm a card carrying weenie.

So what I do is I triple it.

I take the methadone dose, multiply by three, and that's your oral morphine dose.

The reason I don't do four point seven is it's still gonna take days to get that methadone out of the body.

So I'm conservative, I'm very generous with the breakthrough.

And then tell you and I and patients get this.

If you explain it to them, it's gonna take five days to get the full effect, it's gonna take five days to get the drug out of your body.

Hang with me, use the breakthrough.

They get it and they're willing to be your partner in this.

Well, d the rule I use is ten to fifteen percent, but I do think sometimes, um, and often I will recommend this.

When a nurse calls me, I'll say, So when you call the prescriber, here's what you should do.

So let's say somebody was on MS Cotton thirty Q twelve, that's sixty.

Ten percent would be six, fifteen percent uh would be nine, they're both goofy numbers.

So often I will ask the nurse to ask the prescriber for two orders.

Morphine five milligrams, Q two PRN moderate pain, or morphine ten milligrams, Q two PRN severe pain.

Gives the patient a little latitude there.

And often we'll have two strengths of breakthrough dosing available depending on what they're gonna do.

If they have idiopathic breakthrough pain, maybe the five milligrams will get the job done.

But when the nurse comes to do wound care, maybe you need the ten milligrams an hour before the nurse comes.

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