Palliative Prescribing Flashcards
In palliative patients, what initial opioid prescription is recommended?
It is recommended that regular oral modified release or oral immediate release morphine, with oral immediate release morphine for breakthrough pain, is administered
What is the general advice when selecting the most appropriate breakthrough management?
It is generally advised that the same drug should be used for regular and breakthrough pain relief
Which administration route of breakthrough pain provides the fastest relief?
Nasal Sprays
What opioid is recommended in palliative patients with mild to moderate chronic kidney disease?
Oxycodone
Which three opioids are recommended in palliative patients with severe chronic kidney disease?
Alfentanil
Buprenorphine
Fentanyl
In palliative patients, with no co-morbidities, what initial dose of oral morphine is recommended?
It is recommended that a dose of 20-30mg of modified release oral morhpine is administered a day - with 5mg morphine for breakthrough pain
What is the recommendation when increasing the dose of opioids?
It should be increased by 30-50% at a time
How do we calculate the breakthrough dose of morphine?
We divide the daily dose of morphine by 6
How do we convert the dose of oral codeine to oral morphine?
We divide the dose by 10
How do we convert the dose of oral tramadol to oral morphine?
We divide the dose by 10
How do we convert the dose of oral morphine to oral oxycodone?
We divide the dose by 1.5
How do we convert the dose of oral morphine to subcutaneous morphine?
We divide the dose by 2
How do we convert the dose of oral morphine to subcutaneous diamorphine?
We divide the dose by 3
How do we convert the dose of oral oxycodone to subcutaneous diamorphine?
We divide the dose by 1.5
How much oral morphine equates to one transdermal fentanyl 12mcg patch?
30mg
