A 70-year-old man with advanced lung cancer and severe bone pain is on modified-release morphine sulphate 60 mg twice daily and regular laxatives. He ...

Question

A 70-year-old man with advanced lung cancer and severe bone pain is on modified-release morphine sulphate 60 mg twice daily and regular laxatives. He still has severe breakthrough pain several times a day. According to palliative care principles, what is the most appropriate step?

Accepted Answer

Increase the breakthrough dose of immediate-release morphine to approximately one-sixth of the total 24-hour dose and review

Answer

Stop morphine and start high-dose NSAIDs instead

Answer

Avoid increasing opioids because of the risk of addiction

Answer

Start long-term benzodiazepines as the primary analgesic

Answer

Switch to codeine phosphate at an equivalent dose

uk-plab-1 MCQ (SBA): Cancer pain management

A 70-year-old man with advanced lung cancer and severe bone pain is on modified-release morphine sulphate 60 mg twice daily and regular laxatives. He still has severe breakthrough pain several times a day. According to palliative care principles, what is the most appropriate step?