Safe Prescribing

Question 1

Codeine to morphine potency

Answer 1

Codeine = 10% of morphine

Question 1

What anti-emetic should be prescribed as required with opiods?

Answer 1

Cyclizine, ondansetron, and prochlorperazine are used to relieve opioid-induced nausea and vomiting; ondansetron has the advantage of not producing sedation.

Question 2

What laxatives are given with opiods?

Answer 2

Stimulant laxatives such as senna or bisacodyl are usually first-line with the addition of a stool
softener, such as docusate, if required. The aim is to achieve a regular bowel movement without
straining every 1-3 days.

Question 3

What to co-prescribe in a analgesia prescribing station?

Answer 3

Breakthrough analgesia
Cyclizine (anti-emetic)
Senna (laxative)
Naloxone

Question 4

Where to look in the BNF for opioid conversions?

Answer 4

To convert between preparations you need to know the potency of the opioids. You can find
conversion tables within the Prescribing in Palliative Care – Medicines Guidance section of the
BNF.

Question 5

How to reverse warfarin?

Answer 5

Vitamin K (search phytomenidione on BNF)