PSA Pain Management 2

Question 1

A patient on long-term oral morphine develops refractory constipation. Which laxative class is most appropriate?

Accepted Answer

Stimulant (senna)

Answer

Stimulant laxatives such as senna are first-line for opioid-induced constipation because they directly stimulate colonic motility.

Question 2

A patient with eGFR 15 ml/min requires opioid analgesia for cancer pain. Which opioid is most appropriate?

Accepted Answer

Fentanyl

Answer

Fentanyl is preferred in severe renal impairment because its metabolites are not renally excreted and do not accumulate to cause toxicity.

Question 3

An adult weighing 48 kg is prescribed paracetamol for post-operative pain. What is the maximum safe single dose?

Accepted Answer

720 mg

Answer

For patients weighing less than 50 kg, the maximum single dose of paracetamol is 15 mg/kg, giving 720 mg for a 48 kg adult.

Question 4

Which drug combination carries the highest risk of serotonin syndrome?

Accepted Answer

Tramadol + amitriptyline

Answer

Tramadol inhibits serotonin reuptake, and combined with amitriptyline (which also has serotonergic activity), the risk of serotonin syndrome is significantly increased.

Question 5

A patient is prescribed MST Continus 30 mg twice daily. What is the correct breakthrough (PRN) morphine dose?

Accepted Answer

10 mg

Answer

The PRN breakthrough dose should be one-sixth of the total daily opioid dose; 60 mg/day divided by 6 equals 10 mg.

(PSA) Prescribing Safety Assessment Practice Test

(PSA) Prescribing Safety Assessment Practice Test

PSA Pain Management 2