Question

A 68-year-old woman with metastatic breast cancer has severe constant bone pain not controlled by regular oral Paracetamol. She has never had opioids before and is otherwise fit with normal renal function. What is the most appropriate next step in analgesic management according to the WHO ladder?

Accepted Answer

Add a weak opioid such as Codeine to Paracetamol

Answer

Start a strong opioid such as Morphine immediately without titration

Answer

Use only non-pharmacological methods such as TENS

Answer

Prescribe long-term Benzodiazepines for pain

Answer

Stop Paracetamol and give NSAIDs alone

Practice question

A 68-year-old woman with metastatic breast cancer has severe constant bone pain not controlled by regular oral Paracetamol. She has never had opioids before and is otherwise fit with normal renal function. What is the most appropriate next step in analgesic management according to the WHO ladder?