A 67-year-old woman on palliative treatment for metastatic breast cancer is struggling to take her prescribed morphine, causing her discomfort to increase. She is currently prescribed 50 mg BD orally.
What is the best course of action to manage her pain?
You are evaluating a patient with advanced breast cancer. The patient has asked you to fill out a DS1500 form. When is it appropriate to complete this form?
You assess a hospice patient at their residence. They are presently taking 30 mg MST twice a day, which is effectively managing their pain. However, due to their inability to swallow, you decide, after consulting with everyone involved, to transition them to morphine via a syringe driver. What would be the suitable initial dosage for the patient?
The District Nurse requests a prescription for a syringe driver for a patient you assessed earlier in the day. The patient, who is in their late 70s, is dying from metastatic renal cancer. You recommend a 24-hour dose of 60mg of diamorphine. Please provide the correct wording for the prescription.
What is the correct statement regarding the use of opioids in palliative care?
You receive a call from the Coroner’s officer regarding the sudden death of a patient you were treating. Upon reviewing your written report on the patient’s care, you are summoned to appear in person at the Coroner’s court to provide evidence, along with other healthcare professionals who also treated the patient. What is the purpose of this procedure?
Please review the death certificate below:
1a Congestive cardiac failure
1b Essential hypertension
1c
2 Advanced age, type 2 diabetes mellitus
Which one of the statements regarding this certificate is accurate?
You are visiting 84-year-old Mr. Smith who has metastatic lung cancer and has been experiencing nausea and vomiting for the past week. He reports regular nausea, oesophageal reflux, and occasional large volumes of vomit, which provide temporary relief.
Upon conducting a thorough assessment, you suspect that his symptoms are caused by gastric stasis and decide to initiate an anti-emetic.
What is the most suitable medication to begin in this case?
You are assessing a senior gentleman with prostate cancer. Regrettably, his pain is presently uncontrolled with co-codamol 30/500 2 tablets qds and diclofenac 50 mg tds. Your plan is to transition him to oral morphine. Can you provide the conversion factor between oral codeine and oral morphine?
A client is taking tramadol 100 mg qds. Despite this, they are experiencing inadequate pain relief. What is the equivalent 24-hour dosage of oral morphine?