Palliative Prognostic Index — SCE Palliative Medicine MCQ

Instant feedback + full explanation. One question, done properly.

HardEnd of Life CarePalliative Prognostic IndexSCE Palliative Medicine

A patient receives oral oxycodone 30 mg twice daily but must switch to oral morphine because oxycodone is unavailable. What approximate 24-hour oral morphine dose does the Scottish table indicate before a safety reduction?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Oral morphine 120 mg over 24 hours

The oxycodone total is 60 mg in 24 hours. Scottish guidance uses oral oxycodone 5 mg as approximately equivalent to oral morphine 10 mg, so multiplying by two gives 120 mg oral morphine per 24 hours. The other doses arise from equal-potency, reversed-ratio, 1.5-times or three-times calculations. Equianalgesic figures are guides rather than automatic prescriptions: switching commonly uses a conservative reduction for incomplete cross-tolerance, frailty, toxicity or organ failure, followed by early reassessment.

Reference: Scottish Palliative Care Guidelines: opioid conversion tables: https://www.rightdecisions.scot.nhs.uk/scottish-palliative-care-guidelines/scottish-palliative-care-guidelines/medicines/medicines-information/choosing-and-changing-opioids-opiates-convertingswitching/opioidopiate-conversion-tables-switching-between-opioid-medicines/