Sun14November1246PM 25

A 69-year-old man with a history of lung cancer and bone metastases, presents with bony pain from his metastases. He is presently taking regular paracetamol.

Which of the following medications would be the next best option for him?

(Please select 1 option)

Naproxen This is the correct answer

Capsaicin

Tramadol

Codeine

Dexamethasone Incorrect answer selected

Explanation

Naproxen is useful as a first line therapy for bony pains secondary to metastases.

The World Health Organization (WHO) recommends a three step analgesic ladder when approaching metastatic bone pain:

Step 1 - non-steroidals such as aspirin, ibuprofen and naproxen

Step 2 - a weak opioid such as codeine and hydrocodone

Step 3 - potent opioids such as morphine and fentanyl.

Concurrent administration of tricyclic antidepressants may aid efficacy.

Reference:

Serafini AN. Therapy of metastatic bone pain. J Nucl Med. 2001;42(6):895-906.

Answer Statistics

1

46%

2

4%

3

13%

4

23%

5

16%

Times answered: 253