He complains of drowsiness and constipation. What is the next step in the management?

A pt who was previously on 120mg slow release oral morphine has had his dose increased to

200mg. He is still in significant pain. He complains of drowsiness and constipation. What is the

next step in the management?

a. Increase slow release morphine dose

b. Fentanyl patch

c. Replace morphine with oral hydromorphone

d. Replace morphine with oxycodone

e. Subcutaneous morphine

Ans. The key is D. Replace morphine with oxycodone.