CHPN Pharmacology & Medication Management Flashcards

What is the equianalgesic oral dose of oxycodone compared to 30 mg of oral morphine?

Answer: 20 mg

20 mg of oral oxycodone is equianalgesic to 30 mg of oral morphine, giving oxycodone roughly a 1.5:1 potency advantage.

A hospice patient with renal failure needs opioid pain management. Which opioid should be avoided?

Answer: Morphine

Morphine's active metabolite (morphine-6-glucuronide) accumulates in renal failure, causing sedation and respiratory depression.

Which co-analgesic is most effective for neuropathic pain in hospice patients?

Answer: Gabapentin

Gabapentin (and pregabalin) are first-line adjuvant analgesics for neuropathic pain, working by blocking calcium channels in the nervous system.

A hospice patient is experiencing terminal restlessness unresponsive to lorazepam. Which medication may be used for palliative sedation?

Answer: Midazolam

Midazolam is a fast-acting benzodiazepine commonly used for palliative sedation in refractory terminal agitation.

What is the role of corticosteroids such as dexamethasone in hospice symptom management?

Answer: Reduce inflammation, appetite stimulation, and relieve nausea and pain from pressure

Dexamethasone serves multiple palliative purposes including reducing tumor-related inflammation, stimulating appetite, and managing nausea and neuropathic pain.

Which antiemetic is most appropriate for nausea caused by opioid-induced gastroparesis in a hospice patient?

Answer: Metoclopramide

Metoclopramide is a prokinetic agent that improves gastric emptying, directly addressing opioid-induced gastroparesis as a cause of nausea.