Mediastinal Syndrome Triple Signs — SCE Palliative Medicine MCQ

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HardPain ManagementMediastinal Syndrome Triple SignsSCE Palliative Medicine

A patient takes oxycodone MR 20 mg twice daily plus two 10 mg immediate-release doses each day. Oral administration fails; pain is controlled and renal function is stable. What approximate 24-hour SC oxycodone infusion is equivalent?

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Correct answer: D — Oxycodone 30 mg over 24 hours

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

C is correct. Total oral oxycodone is 40 + 20 = 60 mg/24 hours. Oral to subcutaneous oxycodone is approximately 2:1, so divide by 2: 30 mg/24 hours. A and B underdose, D omits the route conversion, and E doubles rather than halves. The conversion is approximate: prescribe an appropriate SC breakthrough dose, review efficacy and toxicity, and reduce conservatively when clinical factors require.

Reference: Scottish Palliative Care Guidelines: opioid conversions: 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/