Question

A 55-year-old man with poorly controlled COPD and heart failure is admitted with an acute exacerbation. After discussion, he chooses a comfort-focused approach and declines intubation. His dyspnoea is severe despite maximal non-opioid measures. What is the most appropriate use of opioids in this context?

Accepted Answer

Start low-dose opioids and titrate to relieve dyspnoea, explaining intent is symptom relief, not life-shortening

Answer

Avoid opioids because they may depress respiration

Answer

Use opioids only if prognosis is less than 24 hours

Answer

Give high-dose opioids rapidly to induce unconsciousness

Answer

Refuse opioids because he declined intubation

Practice question