Certified Hospice and Palliative Assistant (CHPNA) Practice Test

Upon performing an equianalgesic conversion for opioid use, what adjustment should be made?

1. Increase the dose by 25%

2. Maintain the same dose

3. Reduce the dose by approximately 25%

4. Use only oral opioids

The correct answer is: Reduce the dose by approximately 25%

In the context of equianalgesic conversion for opioid use, reducing the dose by approximately 25% is a critical safety measure known as a dose reduction factor. This adjustment is applied due to the incomplete cross-tolerance that can occur when switching from one opioid to another. Patients may not respond identically to different opioids; thus, even if the dosages seem equivalent based on conversion guidelines, the body may not metabolize the new opioid in the same way as the previous one. This reduction aims to prevent overdose and manage potential adverse effects that can arise from an unfamiliar opioid. It's important for healthcare providers to recognize that even though two opioids may provide similar pain relief, the patient’s reaction to them can vary significantly. Therefore, a cautious approach that includes a reduction in dosage ensures that patients remain within a safe therapeutic window as they transition to a new opioid regimen. Maintaining the same dose or increasing it does not account for these variabilities and can put the patient at risk for serious side effects. Additionally, the choice of using only oral opioids does not address the overarching principle of managing dosage when converting medications. Thus, the adjustment to reduce the dose is not only a standard practice but essential for patient safety and comfort in pain management