ABIM Palliative Care Practice Questions - ABIM Hospice And Palliative Medicine Certification Exam

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A 71-year-old woman on the medicine service with advanced cancer is on scheduled oxycodone 15 mg PO Q4H (90 mg/day) with good pain control but intolerable nausea. You rotate to oral hydromorphone with a 25-50% reduction for incomplete cross-tolerance. Using standard equianalgesic dosing, what is the most appropriate starting daily dose of oral hydromorphone?

Hydromorphone 7.5 mg/day (1 mg Q4H) Hydromorphone 17-25 mg/day (~3-4 mg Q4H) Hydromorphone 45 mg/day (7.5 mg Q4H) Hydromorphone 3 mg/day (0.5 mg Q4H)

Correct Answer:

Hydromorphone 17-25 mg/day (~3-4 mg Q4H)

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