A case of amyotrophic lateral sclerosis treated with sustained high dosage morphine sulfate for refractory dyspnea

Abstract

We report the case of a 70–year–old woman with amyotrophic lateral sclerosis treated with a sustained high dose of morphine sulfate for refractory dyspnea ; she was initially treated with high dose morphine hydrochloride for short intervals intermittently. The switch from treatment with morphine hydrochloride to treatment with morphine sulfate was performed safely and was found to be effective, especially in preventing “end-of-dose failure” dyspnea.

Additionally, we examined several different solvents and morphine sulfate injection devices for administration via enteral feeding tube. Administration of sustained morphine sulfate dissolved in Yakuruto^® by using a suspension bottle was found to be convenient and effective.