Fao Sqad Please

[Calicogirl]

Hi Sqad, What are the therapeutic levels of morphine in an adult male 77 year weighing around 14 stone please? My grandfather has recently sadly died ( hence we're back in the UK at the mo, plus sorting our new house here out). He was actually going on very well, until they upped his morphine dose via patch from 5mcg to 10 mcg. Two days later my mother found him with pinpoint pupils, clammy and pale, and called the Dr who came out and thought it was Morphine toxicity. He was then taken to hospital where for the next 10 hours he was not treated for morphine toxicity or indeed for anything really. My mother was with him the entire time and he was only semi conscious yet when he was imminently dying they popped up with they had a DNR conversation him and he didn't want to be resusitated which is an outright lie. They refused to resusitate him despite protests about that conversation never being able to have happened.
We all acknowledge he was terribly poorly with lots of co-morbidities and we don't think our GP would have intentionally caused an overdose, but we are all furius and very distressed about the A&E staff not treating him for what our GP had him admitted for and it was apparently ragingly apparent that he had too much morphine in the morning and he didn't die until midnight.
He's now going for a post mortem out of county on that basis as eh hospital are saying he died of a 'chest infection' despite the hospital at home report in his yellow book saying the previous day that there was no sign of a chest infection and the Community Matron visiting and saying the same. So ahead of instructing experts should anything untoward appear I was wondering if you could help me with toxicity levels / theraputic levels so we have a vague idea of what we need to be researching.

Many thanks x

[Calicogirl]

Hi Bedknobs tbh I don't know much about which patches he was using as I've not been living here, but I know he's had patches which were doubled from 5 to 10 and also took Oramorph 5-10ml for breakthrough pain. I can find out more detail for you tomorrow if that would be helpful? x
Thank you everyone for your kind thoughts.

[bednobs]

It would be helpful if you don't mind. Don't make it a priority though because I probably won't be able to answer satisfactorily anyway. Those doses you mention seem incredibly small to medium but I suppose it depends what it was for. I would imagine you would like to be reassured that he wasn't just abandoned because of his age. Medicine doest always have the right answer all the time and ive see people have the reversal to morphine and absolutely scream the roof off immediately because all their well controlled pain has sudnly come back. Sometimes medicine is weighing up the best of two evils