16th February 2025

A 72-year-old-man with a background of metastatic prostate cancer, CKD 4, type 2 diabetes, COPD, and peripheral vascular disease

A 72-year-old-man with a background of metastatic prostate cancer, CKD 4, type 2 diabetes, COPD, and peripheral vascular disease is seen by you on the ward to review his pain medications. His pain is generally well controlled on a 25 mcg/h fentanyl patch. However, he has been struggling to get out of bed due to pain on mobilising. Due to this, he has developed a pressure sore on his right heel and is declining dressing changes as he finds this too painful. He has been reviewed by the dietician who has optimised his oral intake for good healing. From the options below which medication is most appropriate to try?

Select the SINGLE most appropriate option from the list below. Select ONE option only.