REQ: alternatives to morphine

Nurses at a hospice in France are telling a relative with terminal cancer
that they have no alternative to the morphine which causes her unable to
keep food down, so they are giving her asprin tablets instead!

An acquaintance who shares an intolerance to morphine has recommended
Pethadine because of recent experience with 4-hourly IV Pethadine
continuously for 6 weeks due to a back injury but the French nurses say
Pethadine is not available in France. (This seems to be untrue, too.)

The patient in question has only weeks to live, and it seems cruel that
she should be made to suffer in this way. Could readers in these groups
with experience in palliative care suggest actual names of alternative
painkillers that the family of this patient could request?

Please list only drugs that are suitable to morphine-intolerant patients.
--
John Savage (my news address is not valid for email)

"John Savage" <rookswood@suburbian.com.au> wrote in message
news:061124000102607.24Nov06$rookswood@suburbian.c om...
> Nurses at a hospice in France are telling a relative with terminal cancer
> that they have no alternative to the morphine which causes her unable to
> keep food down, so they are giving her asprin tablets instead!
>
> An acquaintance who shares an intolerance to morphine has recommended
> Pethadine because of recent experience with 4-hourly IV Pethadine
> continuously for 6 weeks due to a back injury but the French nurses say
> Pethadine is not available in France. (This seems to be untrue, too.)
>
> The patient in question has only weeks to live, and it seems cruel that
> she should be made to suffer in this way. Could readers in these groups
> with experience in palliative care suggest actual names of alternative
> painkillers that the family of this patient could request?
>
> Please list only drugs that are suitable to morphine-intolerant patients.
> --
> John Savage (my news address is not valid for email)

For most patients who can't tolerate morphine, hydromorphone (Dilaudid) is
an excellent alternative. Fentanyl patches are also a useful tool

>> Nurses at a hospice in France are telling a relative with terminal cancer
>> that they have no alternative to the morphine which causes her unable to
>> keep food down, so they are giving her asprin tablets instead!
>>
>> An acquaintance who shares an intolerance to morphine has recommended
>> Pethadine because of recent experience with 4-hourly IV Pethadine
>> continuously for 6 weeks due to a back injury but the French nurses say
>> Pethadine is not available in France. (This seems to be untrue, too.)
>>
>> The patient in question has only weeks to live, and it seems cruel that
>> she should be made to suffer in this way. Could readers in these groups
>> with experience in palliative care suggest actual names of alternative
>> painkillers that the family of this patient could request?
>>
>> Please list only drugs that are suitable to morphine-intolerant patients.
>> --
>> John Savage (my news address is not valid for email)
>
> For most patients who can't tolerate morphine, hydromorphone (Dilaudid) is
> an excellent alternative. Fentanyl patches are also a useful tool

Is the morphine making her nauseous or is it the cancer or is it that she
just doesn't want to eat , which would be absolutely normal in advanced
cancer? Is she taking an anti-emetic?
When you get to the terminal stages oral analgesics may not be absorbed and
a fentanyl patch or syringe driver may be more useful. Oral preparations of
opiates are often more nauseating than injected ones.
I haven't seen pethidine in a few years and there was some talk of not
making it any more in Australia and, I suspect, in other countries because
its side effects outweighed its usefulness.
MIKE

Steph schreef:
> "John Savage" <rookswood@suburbian.com.au> wrote in message
> news:061124000102607.24Nov06$rookswood@suburbian.c om...
>
>> Nurses at a hospice in France are telling a relative with terminal cancer
>> that they have no alternative to the morphine which causes her unable to
>> keep food down, so they are giving her asprin tablets instead!
>>
>> An acquaintance who shares an intolerance to morphine has recommended
>> Pethadine because of recent experience with 4-hourly IV Pethadine
>> continuously for 6 weeks due to a back injury but the French nurses say
>> Pethadine is not available in France. (This seems to be untrue, too.)
>>
>> The patient in question has only weeks to live, and it seems cruel that
>> she should be made to suffer in this way. Could readers in these groups
>> with experience in palliative care suggest actual names of alternative
>> painkillers that the family of this patient could request?
>>
>> Please list only drugs that are suitable to morphine-intolerant patients.
>> --
>> John Savage (my news address is not valid for email)
>>
>
> For most patients who can't tolerate morphine, hydromorphone (Dilaudid) is
> an excellent alternative. Fentanyl patches are also a useful tool
>
>
>
I know of some people that use methadon instead of morfine.

Anne