Examples of Changing Routes of Administration

Work through the following examples of changing routes of administration. Feel free to use your equianalgesic table and calculator. The point of the examples is to get comfortable working with the table, not to memorize it!

N.H., an 80 year old retired teacher with pancreatic cancer


Audio  
(optional- 47 sec)

Case:

Give him anti-emetics and resume oral morphine after his vomiting ceases

Apply a fentanyl patch

Look into non-opioid analgesics, becauseopioids have nausea and vomiting as a potential sideeffect.

Start IV morphine and titrate the doseaggressively, assessing every 15 minutes for pain relief

Arrange for the placement of an epiduralmorphine delivery system

Answer:

 
Equianalgesic table



Dose Equivalents for opioid analgesics in opioid-naive adults and children ≥ 50 kg body weight.
*Fentanyl should not be used in opioid naive patients. Use manufacturer's table for dosing after patient is established on another opioid.