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Mr B takes oxycodone modified release 30mg bd plus 8 x co-codamol 30/500 each day. According to the ANZCA morphine calculator, what is his daily morphine equivalent dose of opioids?
Mrs C takes Tramadol 100mg qds daily and has agreed to try tapering the dose of tramadol. What is the smallest % reduction of her current daily MED that she can make using available dose units?
Ms X attends for a PROMPPT pain management review. She has widespread persistent pain and has been diagnosed with Fibromyalgia (also classified as primary chronic pain). Ms X is currently prescribed dihydrocodeine 120mg bd, but this doesn’t help. In the past she has tried co-codamol and NSAIDs without success. She tells you that she would be willing to try reducing the dihydrocodeine if you can suggest an alternative medicine to help. Which of the following is the most appropriate response?
Mr H is an 78 year old gentleman with osteoarthritis. He reports pain in most of his joints and says it is worst in his knees. Mr H is prescribed a buprenorphine 7-day patch at a dose of 5mcg/hour and gabapentin 300mg tds. He is also treated for hypertension and AF (ramipril, bendroflumethizaide, digoxin and rivaroxaban). Mr H is adamant he does not want to change the buprenorphine patch as he feels his mobility has improved since starting this and he does not notice any side-effects. He does not know what effect the gabapentin has and wonders if it may be making him a bit forgetful. When negotiating a management plan with Mr H, which of the following is likely to be the most effective approach?