Morphine and increased secretions

[Emily B.]

Hello all, just wondering if anyone has had increased secretions with using morphine under the tongue? My PALS swears that the secretions are worse once he takes the morphine, but Hospice has advised us to use the morphine whenever he feels that tightening in his chest which is usually a precursor to using the cough assist and suction machine for a period of time. I appreciate this help!

 

[lgelb]

Since morphine relaxes the muscles, that is quite possible. It is a tradeoff, but if you haven't tried going without/reducing the dose of the morphine when his chest tightens, it is worth trying. Instead, you could try something weaker than morphine (like codeine), using steam or humidification at that point, adjusting his position, etc.

There is nothing intrinsically wrong with using the CA/suction such that you "need" to avoid it -- if secretions are building up, regular use when needed could actually reduce the buildup, if that made sense. For some people, the reverse is true so you have to see how his situation nets out.

There are also our previous threads (see search link top right) on reducing secretions without creating dry buildup, like using papaya/pineapple tablets or juice, keeping hydrated, keeping PAP chamber/hoses/filters clean, positioning as upright as possible when awake, etc.

Best,
Laurie

 

[notBrad]

Funny thing, I use the oral type, we put it in my peg, and my wife swears it reduces phlegm and saliva. Go figure. The other thing is I take a percocet at bedtime and I have no secretions until about an hour after waking.

 

[Emily B.]

Since morphine relaxes the muscles, that is quite possible. It is a tradeoff, but if you haven't tried going without/reducing the dose of the morphine when his chest tightens, it is worth trying. Instead, you could try something weaker than morphine (like codeine), using steam or humidification at that point, adjusting his position, etc.

There is nothing intrinsically wrong with using the CA/suction such that you "need" to avoid it -- if secretions are building up, regular use when needed could actually reduce the buildup, if that made sense. For some people, the reverse is true so you have to see how his situation nets out.

There are also our previous threads (see search link top right) on reducing secretions without creating dry buildup, like using papaya/pineapple tablets or juice, keeping hydrated, keeping PAP chamber/hoses/filters clean, positioning as upright as possible when awake, etc.

Best,
Laurie

Would the pineapple juice work if given via the peg or does it have to be swallowed. It was too thin for him to swallow.

 

[lgelb]

You can put the juice in the PEG, straight or thinned.