Fentanyl vs Morphine

[Classair]

Our med units now carry no Morphine it was replaced by Fentanyl, whats your all's take on

"FONA instead of MONA"

[spenac]

Might want to spell check. What was the reason given for the change? Why did they choose to replace rather than add an additional med?

[Classair]

spenac, Thanks I just woke up getting use to those 7PM to 7AM shifts are murder. They never gave us a reason just did it.

[spenac]

I definitely understand. Glad you were able to edit it in time. I hate when services make drastic changes w/o explanation. Yes they do not have to but respect should cause them to explain.

[ateupmedic3033]

Fentanyl's onset of effects is faster than Morphine, making it easier to titrate to effect while you are still sitting 18 inches from the cot. It also avoids the histamine-mediated hypotension common with morphine.

I think Morphine hung around so long because of it's supposed effects on reducing preload, which we now know isn't all that much, and not all that important either. Effective pain relief results in less catecholamine release, which results in less myocardial work and irritability, and ultimately a smaller MI. Fentanyl is a better pain reliever than Morphine, and it's perfect for prehospital use.

[Classair]

Look at the bright side they also gave us 16 new LIFEPAK 12 Defibrillator/Monitors.

[AZCEP]

Fentanyl is a much better option, but Morphine definitely has it's place. Having a choice, I'd want the Fentanyl, unless having both was an option.

The short duration of Fentanyl can make it difficult to maintain analgesia.

[akroeze]

I guess the question is, are there any things that you absolutely need morphine for that fentanyl is inappropriate?

[aussiephil]

We use Fentanyl Intra Nasal with good effect here. It appears to be more versatile with a generally shorter half life. That being said, when it was introduced as an addition to our analgesia kits, it was made quite clear that Morphine was & always will be the gold standard in pain managment

Phil

[ERDoc]

Does anyone carry Dilaudid?