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Author(s):  Prince Shelly J

Issue:  Jan/Feb 2000 - Compounding for Pain Management
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Abstract:  The reader is shown how to perform calculations for four problems. In the first, a patient who has been taking morphine sulfate complains of grogginess. Upon questioning, he also admits to taking paregoric for gastrointestinal problems. The reader is given a formulation for paregoric and shown how to calculate the percent strength of morphine in the formula and the quantity of morphine per day the patient is receiving from the paregoric. The second involves a Duragesic-50 transdermal system and shows the reader how to calculate the quantity of fentanyl delivered daily, the quantity of fentanyl remaining in the patch when it is removed and the percent of total drug remaining in the patch after it is removed. The third involves a dose for transmucosal fentanyl in patients over 65 years old and shows how to calculate the dose for a 70-year-old woman weighing a specified weight. The fourth involves a patient receiving bupivacaine via an intrathecal pump. The reader is shown how to calculate the infusion rate for the pump, given the concentration of bupivacaine in the pump reservoir, and the length of time this volume of infusion will last.

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