skip to main content

Art Therapy Evidence in Palliative Care — SCE Palliative Medicine MCQ

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

HardPsychological & PsychiatricArt Therapy Evidence in Palliative CareSCE Palliative Medicine

A patient taking oral modified-release morphine 60 mg twice daily develops troublesome hallucinations. Renal function is stable and oral opioid rotation to oxycodone is chosen. Using oral morphine:oral oxycodone = 2:1 and reducing the calculated oxycodone dose by 30% for incomplete cross-tolerance, which starting regular regimen is closest?

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

Reveal the answer and explanation

Correct answer: B — Oxycodone modified release 20 mg twice daily

The current oral morphine dose is 60 mg twice daily = 120 mg/24 hours. Dividing by 2 gives an approximate oral oxycodone equivalent of 60 mg/24 hours. A 30% cross-tolerance reduction gives 42 mg/24 hours; rounding down to a practical regimen gives 40 mg/24 hours = 20 mg twice daily. Prescribe an appropriate immediate-release breakthrough dose and monitor pain, hallucinations, sedation and respiratory rate. Conversion ratios are approximate, not exact.

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