Palliative Care - Pain

Question 1

What are the general conversions for morphine - Oral to Subcut, breakthrough dosing, and dose increase?

Answer 1

The general conversions for morphine are:

• Oral to subcutaneous: divide oral dose by 2
• Breakthrough dosing: divide 24 hour requirement by 6
• Dose increase: increase by 30 to 50% of the previous dose

Question 2

What is the drug of choice for reducing pain and discomfort of mucositis in palliative care?

Answer 2

Benzydamine Hydrochloride

Question 3

What can respiratory secretions and bowel colic be treated with?

Answer 3

Hyoscine hydrobromide

Hyoscine butylbromide

Glycopyrronium bromide

Question 4

In severe, moderate, renal impairment (CKD), what drugs can you give at what eGFR?

Answer 4

Severe Renal Impairment, (GFR <10mL/min/1.73²) - Buprenorphine or fentanyl (fenTENyl), alfentanil

Moderate Renal Impairment, (GFR 10-50mL/min/1.73²) - Oxycodone

OR

eGFR > 60 = morphine
eGFR 30-60 = oxycodone
eGFR < 30 = alfentanil

Question 5

What is MST?

Answer 5

Morphine Sulfate