Part 5 My experience with hospice services is that it is considered to be comfort measures. Converting her current dose of morphine ER 30mg BID would yield a Fentanyl 25mcg patch Q3 days. For breakthrough pain Roxicodone oral suspension 20mg/mL can be used. Generally, the oral suspension of Roxicodone is only used for opioid tolerant patients. Given this has been on opioids for longer than 3 months she would be considered opioid tolerant at this time. Her other medications need to be adjusted or discontinued because she is having swallowing difficulties. The metoprolol succinate ER and amiodarone cannot be crushed and if you crush the levothyroxine it may alter its effects. But as I had stated earlier those who are admitted to hospice services are usually only given comfort measures and all other medications are discontinued.


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