Professional and Linguistic Assessments Board (PLAB) Practice Exam

What is the calculation method for determining breakthrough analgesia dose?

1. Multiply opioid use by 6

2. Divide 24-hour opioid use by 6

3. Add 24-hour opioid use to 6

4. Divide opioid use by 24

The correct answer is: Divide 24-hour opioid use by 6

The calculation method for determining the dose of breakthrough analgesia is based on a common guideline which suggests using a fraction of the patient's total daily opioid consumption. Specifically, the approach involves dividing the total amount of opioids consumed over a 24-hour period by a factor of 6. This method is grounded in clinical practice to ensure that patients receive an adequate but not excessive dose for breakthrough pain. By dividing the 24-hour opioid use by 6, healthcare providers can calculate an appropriate dose of rescue medication that is roughly 10-20% of the total daily opioid regimen. This fraction aims to manage breakthrough pain effectively while considering the patient's existing opioid tolerance and preventing overdose. This calculation method helps clinicians tailor pain management to individual patient needs, ensuring both efficacy and safety. It’s essential for managing cases where a patient is already on a regimen of around-the-clock opioids and experiences additional, acute episodes of pain that are not controlled by their baseline dose.