Palliative med

Question 1

What is the calculation for oral to subcutaneous morphine conversion?

Answer 1

Divide by two

Question 2

What is the calculation for oral codeine to oral morphine conversion?

Answer 2

Divide by 10

Question 3

How much increase if pain not controlled?

Answer 3

Increase morphine doses by 30-50%

Question 4

What is the appropriate dosing for breakthrough opioids ?

Answer 4

Breakthrough opioids should be dosed between one-sixth and one-tenth of the total daily dose of maintenance opioids

Question 5

How to convert from oral morphine to SC diamorphine?

Answer 5

Divide by 3

Question 6

What is used first-line to manage secretions in a palliative care setting?
What other condition does it treat?

Answer 6

Hyoscine hydrobromide or hyoscine butylbromide
Bowel colic

Question 7

What is the treatment of hiccups in palliative care?

Answer 7

Chlorpromazine or haloperidol

Question 8

What is the next line if metastatic bone pain does not respond to opioids?

Answer 8

Bisphosphonates (intravenous pamidronate and zoledronic acid) or radiotherapy

Question 9

What is used in reducing the discomfort associated with a painful mouth that may occur at the end of life?

Answer 9

Benzydamine hydrochloride mouthwash or spray