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Morphine in severe CKD — GPhC CRA MCQ

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ModerateRenal and Hepatic ImpairmentMorphine in severe CKDGPhC CRA

A patient with eGFR 18 is prescribed morphine oral solution and becomes increasingly drowsy after small doses. What is the most appropriate alternative?

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Correct answer: A — Discuss a safer opioid choice and dose with the prescriber

Morphine metabolites accumulate in severe CKD, so opioid choice and dose need specialist prescriber review. This makes discuss a safer opioid choice and dose with the prescriber the single best answer in this scenario. The other options would either miss the key safety issue, delay appropriate review, or fail to meet the relevant clinical or professional requirement.

Reference: BNF; palliative care guidance