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Early Palliative Care Temel — SCE Medical Oncology MCQ

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HardLung CancerEarly Palliative Care TemelSCE Medical Oncology

A patient with stable cancer pain takes modified-release oral morphine 37.5 mg twice daily, with negligible rescue use. Oral treatment is no longer practical. Using the Scottish palliative conversion table, which initial transdermal plan is closest?

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Correct answer: D — Use fentanyl 25 micrograms/hour, oral morphine 10–15 mg as needed and review after 72 hours

The total oral morphine dose is 75 mg per 24 hours, within the 60–90 mg band corresponding to a 25 microgram/hour fentanyl patch. Breakthrough oral morphine is 10–15 mg, and patch efficacy is judged after about 72 hours. Omitting rescue analgesia or choosing a higher patch risks undertreatment or overdose.

Reference: Scottish Palliative Care Guidelines: fentanyl patches. https://www.rightdecisions.scot.nhs.uk/scottish-palliative-care-guidelines/pain/pain-medicines-analgesics/fentanyl-patches/