DrVirgo
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9. A 48 year-old man with advanced metastatic gastric cancer is admitted to the hospital because of severe abdominal pain High doses of oral analgesics, including numerous opioids, nonsteroidal anti-inflammatory drugs, and tricyclic agents, have not been successful in managing the pain Morphine administered by intravenous infusion successfully controls his pain, but the doses needed cause respiratory depression. He has repeatedly stated that he does not want cardiopulmonary resuscitation and that he wishes "to die with dignity without unnecessary pain." Which of the following is the most appropriate course of action?
A) Administer the lowest dose of morphine that relieves pain, even if it depresses respiration
B) Decrease the dose of morphine and administer an anxiolytic
C) Decrease the dose of morphine, explaining that he will have to tolerate some pain
D) Discontinue morphine and try different analgesics
E) Increase the dose of morphine progressively until the patient stops breathing
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| tolito
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A?
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| endocrine
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i wld also go for a
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| vanshita
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b?
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| robin082006
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B
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| star1
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D
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| mjl1717
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d
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| yasmeen
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its a.u must keep him pain free opioids r strongest analgesics.
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| docswapna
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I guess its A
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| young_doc
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Can't be D. The stem clearly states that other pain relief meds didn't work.
I go for A also. Patient's wishes are for him to be painless. (anxiolytics, B, will not relieve pain)
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| khorshid
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A(end stage pt which wishes not to be in pain)
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| Allymd
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Its confusing, but its said that you can't help the patient actively to die, but you can administer pain killers even if it "coincidentally" causes the patient death... so a???
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| smal
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mmmmm
i think A.
morphine is the most potent analgesic in Ca?
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