An 89-year-old man with end-stage renal disease becomes drowsy and myoclonic after escalating analgesia. He has metastatic prostate cancer and poor

Question

An 89-year-old man with end-stage renal disease becomes drowsy and myoclonic after escalating analgesia. He has metastatic prostate cancer and poor oral intake. eGFR is 12 mL/min/1.73m2. Current medicines include morphine, senna and metoclopramide. Which medication should be reviewed?

Accepted Answer

Morphine

Answer

Paracetamol if used

Answer

Senna

Answer

Metoclopramide as the sole cause

Answer

Mouth care gel

Opioid renal failure — DGM MCQ

An 89-year-old man with end-stage renal disease becomes drowsy and myoclonic after escalating analgesia. He has metastatic prostate cancer and poor oral intake. eGFR is 12 mL/min/1.73m2. Current medicines include morphine, senna and metoclopramide. Which medication should be reviewed?