always make sure that appropriate medication is available to treat breakthrough pain
this should be equivalent to a 4-hourly dose (recommended dose of normal release morphine for breakthrough pain is the equivalent up to one sixth of the total 24 hour morphine dose)
examples:
for a daily dose is MST 30mg bd, breakthrough pain dose is 60/10mg = 10mg 4-hourly prn
for MST 600mg bd, breakthrough pain dose is 1200/6mg = 200mg 4-hourly prn
Reference:
(1) West Midlands Palliative Care Physicians (2007). Palliative care - guidelines for the use of drugs in symptom control.
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