Palliative Care

Question 1

How to convert oral morphine to SC diamorphine?

Answer 1

Diamorphine SC & IV is 3x stronger than oral morphine

So divide total daily dose of oral morphine by 3 if converting to subcut diamorphine

Question 2

How do you convert oral morphine to subcut morphine?

Answer 2

Half the dose

e.g if moving to syringe driver (hence subcut morphine) then if on 120mg oral morphine in total per 24 hrs then = 60mg/24 hrs subcut morphine

Question 3

What is the first line antiemetic used for N&V associated with raised ICP?

Answer 3

Cyclizine

(often used in conjunction with Dexmethasone)

Question 4

What proportion of the total daily dose of opioids should be offered for breakthrough pain?

Answer 4

1/6th to 1/10th of the 24 hour dose