Approved Hospital Formulary
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Approved Hospital Formulary
PCA Dose Limits
IV PCA
hydromorphone (30 mg/30 mL) hyrdromorphone
(300 mg/30 mL)
morphine
(30 mg/30 mL)
morphine
(300 mg/30 mL)
Loading Dose Allowable Range 0.1 - 2 mg 1 - 8 mg 0.1 - 10 mg 1 - 15 mg
PCA Dose Allowable Range 0.1 - 1 mg 1 - 4 mg 0.1 - 5 mg 1 - 9 mg
Continuous Rate Allowable Range 0.1 - 3 mg/hr 1 - 6 mg/hr 0.1 - 20 mg/hr 1 - 20 mg/hr
Dose Limit 7 mg 25 mg 20 mg 30 mg
Time Interval 1 hour 1 hour 1 hour 1 hour
Hospice
hydromorphone (30 mg/30 mL) hyrdromorphone
(300 mg/30 mL)
morphine
(30 mg/30 mL)
morphine
(300 mg/30 mL)
fentanyl
(1500 mcg/30 mL)
Loading Dose Allowable Range 0.1 - 2 mg 1 - 20 mg 0.1 - 10 mg 1 - 20 mg 5 - 250 mcg
PCA Dose Allowable Range 0.1 - 2.5 mg 1 - 20 mg 0.1 - 5 mg 1 - 10 mg 5 - 100 mcg
Continuous Rate Allowable Range 0.1 - 4 mg/hr 1 - 40 mg/hr 0.1 - 20 mg/hr 1 - 40 mg/hr 5 - 250 mcg/hr
Dose Limit 10 mg 110 mg 20 mg 50 mg 650 mcg
Time Interval 1 hour 1 hour 1 hour 1 hour 1 hour

Pharmacy Phone Numbers
Memorial Pharmacy (Glenwood) 423-495-8380
Memorial Hixson Pharmacy 423-495-7137
Stat 423-495-7470
Outpatient 423-495-8981
Chemo 423-495-7475
Surgery 423-495-8779

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