Treatment of acute pulmonary Oedema

Treatment of acute pulmonary
edema
As Easy as 'LMNOP'
Remember the mnemonic LMNOP
when treating a patient with acute
pulmonary edema:
Lasix® (furosemide) intravenous
(IV), one to two times the patient's
usual dose, or 40 mg if the patient
does not usually take the drug.
Morphine sulfate. Initial dose, 4 to
8 mg IV (subcutaneous
administrationis effective in milder
cases); may repeat in 2 to 4 hours.
Avoid respiratory depression.
Morphine increases venous capacity,
lowering left atrial pressure, and
relieves anxiety, which reduces the
efficiency of ventilation.
Nitroglycerin IV, 5 to 10 ug/min.
Increase by 5 ug/min q 3 to 5
minutes. Reduces left ventricular
preload. Caution: may cause
hypotension.
Oxygen, 100% given to obtain an
arterial PO2>60 mm Hg.
Position patient sitting up with legs
dangling over the side of the bed.
This facilitates respiration and
reduces venous return.