Palliative

Question 1

What is the conversion from morphine to oxycodone

Answer 1

20mg PO morphine = 10mg PO oxycodone

Question 2

What is the conversion of codeine to morphine

Answer 2

60mg PO codeine = 6mg PO morphine

Question 3

WHO pain ladder principles of analgesic use

Answer 3

Take by mouth where possible
Take by the clock (regularly)
Guided by the ladder (step up)
Ensure individualised treatment
Use adjuvant drugs

Question 4

Steps of the WHO pain ladder

Answer 4

1. Non opioid +/- adjunct - paracetamol, NSAIDs, aspirin
2. Weak opioid +/- non opioid +/- adjunct - codeine, dihydrocodeine, tramadol
3. Strong opioid +/- non opioid +/- adjunct - morphine, fentanyl

Question 5

How to convert from oral to sc morphine

Answer 5

Divide total dosage in 24hr by 2

Question 6

What can help metastatic bone pain

Answer 6

Analgesia
Bisphosphonates
Radiotherapy

Question 7

Choice of analgesic for renal impairment in palliative patient

Answer 7

Fentanyl
Buprenophine

Question 8

What should the dose of oral morphine be for breakthrough pain

Answer 8

1/6th of daily morphine dose

Question 9

What is used for analgesia in palliative patinets with mild - moderate renal impairment

Answer 9

Oxycodone

Question 10

What is used for analgesia in palliative patinets with mild - moderate renal impairment

Answer 10

Oxycodone

Question 11

What is used for treatment of headaches caused by raised ICP

Answer 11

Dexamethasone

Question 12

What should be used as anti emetic that is due to gastric dysmotility and stasis

Answer 12

Metoclopramide

Question 13

What is the first line anti emetic for intracranial causes of N&V

Answer 13

Cyclizine