Pharmacology Book

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Patient Controlled AnalgesiaAka: PCA Pump

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  1. Step 1: Calculate hourly dose for morphine
    1. Typical Hourly Morphine Dose (mg/hour): (100 - age)/24
      1. Age 30: 3 mg hourly morphine dose
      2. Age 50: 2 mg hourly morphine dose
      3. Age 70: 1.25 mg hourly morphine dose
    2. Typical hourly higher morphine dose (double dose)
      1. Age 30: 6 mg hourly morphine dose
      2. Age 50: 4 mg hourly morphine dose
      3. Age 70: 2.5 mg hourly morphine dose
  2. Step 2: Set Lockout periods and Maximums
    1. Maximum Lockout: 20 minutes
    2. Typical lockout period range: 6 to 12 minutes
    3. Set one hour or four hour maximums
      1. Example for one hour Morphine maximum: 10 mg
      2. Example for four hour Morphine maximum: 40 mg
  3. Step 3: Consider background infusion
    1. Indications
      1. Opioid dependence
      2. Severe pain on awakening
    2. Calculation
      1. Set background rate <50% of anticipated requirements
      2. Typical adult background morphine rate: 1 mg/hour
  4. Step 4: Determine PCA bolus Dose
    1. Bolus dose: (higher dose per hour)/(doses per hour)
    2. For lockout at 10 minute intervals: 6 doses
      1. Example: 30 year old with higher morphine dose: 6 mg
      2. Dose: 1 mg IV morphine boluses up to q10 minutes
  5. Step 5: Convert from Morphine to other medication
    1. Hydromorphone (Dilaudid) 1.5 mg per Morphine 10 mg
    2. Meperidine (Demerol) 75 mg per Morphine 10 mg
  6. Examples for typical 30 year old
    1. Morphine
      1. Boluses: 1 mg
      2. Background infusion rate: 1 mg/hour (optional)
      3. Hourly maximum: 10 mg
      4. Lockout: 6 minutes
    2. Hydromorphone (Dilaudid)
      1. Boluses: 0.1 mg
      2. Background infusion rate: 0.1 mg/hour (optional)
      3. Hourly maximum: 1.5 mg
      4. Lockout: 6 minutes
  7. References
    1. Etches (1999) Surg Clin North Am 79(2):297

Intravenous analgesia unit (C0181331)

Definition (SPN)An infusion pump is a device used in a health care facility to pump fluids into a patient in a controlled manner. The device may use a piston pump, a roller pump, or a peristaltic pump and may be powered electrically or mechanically. The device may also operate using a constant force to propel the fluid through a narrow tube which determines the flow rate. The device may include means to detect a fault condition, such as air in, or blockage of, the infusion line and to activate an alarm.
ConceptsMedical Device (T074)
EnglishIntravenous analgesia unit, Patient controlled analgesic infusion pump, PCA Pump
Spanishbomba de infusión analgésica controlada por el paciente, bomba de infusion analgesica controlada por el paciente, unidad para analgesia intravenosa
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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