ABA Palliative Care

Practice session

A 68-year-old woman with metastatic breast cancer is taking morphine sustained-release 30 mg PO every 12 hours (60 mg/day). Her pain is controlled but she has severe, refractory nausea attributed to morphine. You decide to rotate to oral hydromorphone. Using standard equianalgesic dosing and accounting for incomplete cross-tolerance, what is the most appropriate starting daily dose of oral hydromorphone?

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