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Letters to the Editor
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Morphine sulphate
Repeat prescriptions go unnoticed
From Ms C. F. T. Ralph, MRPharmS, and Ms H. Kreimeyer
In reply to Sally
Haynes’s letter (PJ, 22 January, p86), we would
agree that, in the hospital setting, great care as a rule is taken with
all opioid analgesics and this is certainly a good thing.
Unfortunately, with the current shortage of doctors in the community, and
the extremely high workloads experienced in many practices, repeat prescriptions
of morphine sulphate elixir could almost go through the surgery channels
without anybody noticing. It would not be brought to the doctor’s
attention, unlike a CD POM, prescriptions for which have to be hand-written
by the GP.
The BNF states that regular use of a potent opioid may be appropriate for
certain cases of chronic non-malignant pain; treatment should be supervised
by a specialist and the patient should be assessed at regular intervals.
We do not think this is happening. The trouble is that an increase in dose
is often necessary to maintain the same level of pain, and dependency is
the result. Larger doses produce respiratory depression and hypotension.
Drowsiness may affect performance of skilled tasks and the effects of alcohol
are enhanced.
Catherine Ralph
Hyacinth Kreimeyer
Weston-super-Mare,
Somerset |
The
Pharmaceutical Journal