Palliative Care and Symptom Management Flashcards

Which opioid is considered first-line for moderate-to-severe cancer pain according to the WHO analgesic ladder?

Answer: Morphine

Morphine remains the WHO-recommended first-line strong opioid for moderate-to-severe cancer pain at Step 3 of the analgesic ladder.

A patient on long-acting opioids reports breakthrough pain. The appropriate breakthrough dose is approximately:

Answer: 10–15% of the total daily opioid dose

Breakthrough doses are typically 10–15% of the total 24-hour opioid dose to provide proportionate rapid-onset analgesia.

Which non-pharmacological intervention has the strongest evidence for reducing cancer-related fatigue?

Answer: Aerobic exercise

Aerobic exercise is the most evidence-based intervention for cancer-related fatigue, improving both physical and psychological components.

Which antiemetic is most appropriate for opioid-induced nausea acting via the chemoreceptor trigger zone?

Answer: Prochlorperazine

Prochlorperazine (a dopamine antagonist) acts on the chemoreceptor trigger zone (CTZ), which is the primary mechanism of opioid-induced nausea.

A patient with cancer-related dyspnea refractory to oxygen is best treated with:

Answer: Low-dose opioids

Low-dose opioids are the most evidence-based pharmacological treatment for refractory dyspnea in cancer patients.

Which laxative regimen should ALWAYS accompany opioid therapy to prevent constipation?

Answer: A stimulant laxative such as senna

A stimulant laxative (senna or bisacodyl) should be initiated prophylactically with opioids because tolerance to constipation, unlike other opioid side effects, does not develop.