CFPC CAC Palliative Care Practice Questions - College Of Family Physicians Of Canada Certificate Of Added Competence In Palliative Care Assessment Exam

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A 68-year-old patient with metastatic prostate cancer receiving oral morphine 60 mg twice daily experiences worsening bone pain with a numerical rating score of 8/10. Pain control is inadequate, but renal function is normal. What is the most appropriate initial adjustment to the oral morphine regimen?

Increase oral morphine to 90 mg twice daily and add 15 mg oral morphine as needed every 4 hours for breakthrough pain Discontinue morphine and initiate transdermal fentanyl 50 mcg/hr patch immediately Maintain morphine 60 mg twice daily and add oral meperidine 50 mg every 3 hours for breakthrough pain Switch immediately to oral methadone 20 mg three times daily without dose reduction

Correct Answer:

Increase oral morphine to 90 mg twice daily and add 15 mg oral morphine as needed every 4 hours for breakthrough pain

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