A patient newly diagnosed with cancer is admitted to the hospital, and the provider orders oxycodone [OxyContin] every 4 to 6 hours PRN pain
The patient requests pain medication whenever he reports pain as a 7 or 8 on a scale of 1 to 10 (10 being the worst pain), but he tells the nurse the medication is not working well. The nurse will contact the provider to discuss: a. a fixed dosing schedule for the oxyco-done.
b. intramuscular meperidine [Demerol].
c. intravenous morphine sulfate.
d. transdermal fentanyl.
A
Dosing should be done on a fixed schedule to prevent opioid levels from becoming subtherapeu-tic once patients begin to have more severe pain. IM and IV dosing are more invasive and should not be used unless other methods have failed. Transdermal fentanyl is used for chronic, severe pain in patients tolerant to opioids.
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