16th February 2025

You see a 90-year-old man with metastatic prostate cancer as the nursing staff are concerned that he is more confused

You see a 90-year-old man with metastatic prostate cancer as the nursing staff are concerned that he is more confused. On review of his notes, he has been reporting bilateral leg pain over the last 5 days. His U&Es are shown below:

Na 143 (133 – 145mmol/L) , K 4.5 (3.5 – 5.3 mmol/L), Cr 70 (59-104 µmol/L), eGFR >90 (>90)

His drug chart shows he is on 10 mg morphine modified-release BD but has not taken the most recent dose as the nursing staff were not able to persuade him to take it. When you go to see him, he is restless and will not engage with your questions. Which is the most appropriate medication from the options below?

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