Palliative care 2016

Opioid tolerance in advanced cancer patients? “Progressive need for uptitration of opioid dose to maintain the same analgesic effect” After stabilisation (14d) on oral morphine è VAS-score <3,5 Change of morphine è equivalent dose TTS-fentanyl, oral morphine is free available for break through pain (BTP) Dose fentanyl is up-titrated if oral morphine ≥ 60mg/d for BT Opioid tolerance: 1- Is so important that opioids are best reserved for patients in their last year of life (to prevent analgesic ineffectiveness) 2- Does exist but can not justify witholding opioids 3- Does not exist in cancer patients

4- I don’t know