IV to SC Morphine Conversion — SCE Palliative Medicine MCQ

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EasySyringe Driver & Drug CompatibilityIV to SC Morphine ConversionSCE Palliative Medicine

A patient is receiving a continuous IV morphine infusion of 20 mg over 24 hours via syringe pump and requires conversion to a subcutaneous infusion (CSCI) of morphine. What is the appropriate dose for the CSCI?

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Correct answer: A — SC morphine 20 mg over 24 hours

Explanation lettering: E = shown as A · D = shown as B · A = shown as C · C = shown as D · B = shown as E

The correct answer is E. Morphine given intravenously and subcutaneously is approximately equipotent; pharmacokinetic data show similar overall exposure (AUC) at steady state despite different peak profiles ([pubmed.ncbi.nlm.nih.gov](https://pubmed.ncbi.nlm.nih.gov/40755222/?utm_source=openai)). The SmPC for morphine confirms that reduction applies when converting from oral to IV or SC forms, not between parenteral routes ([medicines.org.uk](https://www.medicines.org.uk/emc/product/13442/smpc?utm_source=openai)). Thus, switching from IV to SC morphine does not require dose adjustment. Options A and B wrongly apply oral‑to‑parenteral conversion ratios. Options C and D represent inverse ratios with no clinical or pharmacological basis in UK practice. Apply this conclusion only to the clinical circumstances stated, with appropriate specialist review, contraindication checks, shared decision-making and follow-up. Reassess if the physiology, treatment response or competing risk changes. The competing options would require a different haemodynamic profile, diagnosis, procedural indication or risk balance from the one described here.

Reference: Actimorph Orodispersible tablets SmPC (eMC) and Gravdahl et al., Br J Clin Pharmacol 2025 pharmacokinetic study (PubMed), https://www.medicines.org.uk/emc/product/13442/smpc

IV to SC Morphine Conversion — SCE Palliative Medicine MCQ

A patient is receiving a continuous IV morphine infusion of 20 mg over 24 hours via syringe pump and requires conversion to a subcutaneous infusion (CSCI) of morphine. What is the appropriate dose for the CSCI?

A patient is receiving a continuous IV morphine infusion of 20 mg over 24 hours via syringe pump and requires conversion to a subcutaneous infusion (CSCI) of morphine. What is the appropriate dose for the CSCI?