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The Annals of Pharmacotherapy: Vol. 37, No. 7, pp. 1132-1135. DOI 10.1345/aph.1C475
© 2003 Harvey Whitney Books Company.
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DRUG INFORMATION ROUNDS

Intraspinal Use of Morphine

Kathryn E Gaudette, PharmD

Specialty Resident, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL

S Jay Weaver, PharmD

Specialty Resident, Drug Information Practice, Department of Pharmacy Practice, College of Pharmacy, University of Florida

Reprints: Kathryn E Gaudette PharmD, H Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Dr., Tampa, FL 33612-9497, FAX 813/979-3994, E-mail katiegaudette{at}hotmail.com

OBJECTIVE: To compare the different sterility standards and the cost issues involved when choosing an opioid product for intraspinal administration.

DATA SOURCES: Literature accessed through MEDLINE and other Internet search engines (September 2002–April 2003) was evaluated. Key search terms included epidural/intrathecal, opioids, sterility, and compounding.

DATA SYNTHESIS: Intraspinal use is prevalent in the area of pain management. Product selection is of utmost importance when administering through the intraspinal route. An evaluation of guidelines on sterility and a cost comparison were conducted.

CONCLUSIONS: The preservative-free commercially available products that are indicated for intrathecal/epidural use are the best alternative due to proper outside testing and stringent quality assurance. The generic morphine preservative-free product may also be considered if proper steps are taken to ensure that the final product is diluted properly.

Key Words: epidural, intrathecal, opioids

Published Online, June 16, 2003. www.theannals.com, DOI 10.1345/aph.1C475




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