Equianalgesic dose calculation guidelines
Case |
Jack Smith is a terminally ill lung cancer patient. Jack Smith’s current pain medication is oxycontin 40mg q 8 hours. Please convert it into an equianalgesic dose of parenteral hydromorphone. | |||||||||||||||||||||||||||
Step 1 |
First determine total 24 hour dose of current drug. The total dose is the product of the unit dose in milligrams and the frequency of administration.
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Step 2 |
Convert total 24 hour dose of current drug to equianalgesic dose of ORAL morphine using the following guidelines:
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Step 3 |
Convert the calculated 24 hour equianalgesic dose of oral morphine to the 24 hour equianalgesic dose of the new opioid:
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Step 4 |
Divide the 24 hour dose of the equianalgesic dose of the new opioid to determine the unit doses and frequency:
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The case: |
Jack Smith is a terminally ill lung cancer patient. Jack Smith’s current pain medication is Morphine sulfate sustained release 45mg every 12 hours. During a clinic visit, Mrs. Smith complains that she has noticed that her husband has developed muscle twitching ever since his Morphine sulfate sustained release was increased to 45mg every 12 hours. You review Mr. Smith’s recent chemistry panel and note that his creatinine is elevated at 2.4. Please convert the transdermal fentanyl into an equianalgesic dose of long acting oxycodone. | |||||||||||||||||||||||||||
Sequential steps |
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