QuestionSBA
QuestionChoice
This would be equivalent to 90mg Morphine sulfate PO daily.
10028545
d
Fentanyl 37.5 microgram/h transdermal patch  72-hourly
QuestionChoice
This would be equivalent to 120mg Morphine sulfate PO daily.
10028544
c
Fentanyl 50 microgram/h transdermal patch  72-hourly
QuestionChoice
Transdermal fentanyl is not available in this preparation.
10028546
e
Fentanyl 90 microgram/h transdermal patch  72-hourly
QuestionChoice
This would be equivalent to 180mg Morphine sulfate PO daily.
10028543
b
Fentanyl 75 microgram/h transdermal patch  72-hourly
QuestionChoice
He is currently receiving 80+80+(8x10) = 240mg Morphine sulfate PO daily. This is equivalent to 100 microgram/h fentanyl using a transdermal patch. More information can be found [here.](https://bnf.nice.org.uk/medicines-guidance/prescribing-in-palliative-care/)
10028542
a
Fentanyl 100 microgram/h transdermal patch  72-hourly
Concept
Chapter
2693
6085
Opioid conversion
Topic
327
Paliative care prescribing
18111
Case Presentation:


A 82-year-old male is brought to the GP by his carer with worsening dysphagia. He has stage 4 Oesophageal cancer for which he is receiving palliative care for.

**PMH** Oesophageal carcinoma, GORD, Hypertension.

**DH** Morphine sulfate M/R 80mg PO BD, Morphine sulfate 10 mg/5 mL solution (Oramorph) 5 mL PO PRN. Paracetamol 1g PO QDS, Ibuprofen 400mg PO TDS, Omeprazole 30mg PO OD, Ramipril 5mg PO OD. He has taken 8 doses of her Oramorph in the last 24 hours.

Due to his worsening dysphagia, the GP decides to convert his analgesic medication to a transdermal fentanyl patch at the same dose equivalent of morphine he is currently receiving.

Question:
Select the most appropriate decision option with regard to his pain management based on these data.
a