A patient newly diagnosed with cancer is admitted to the hospital, and the provider orders oxycodone [OxyContin] every 4 to 6 hours PRN pain. The patient requests pain medication whenever he or she reports pain as a 7 or 8 on a scale of 1 to 10 (10 being the worst pain), but he or she tells the nurse the medication is not working well. The nurse will contact the provider to discuss:

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Dosing should be done on a fixed schedule to prevent opioid levels from becoming subtherapeutic once patients begin to have more severe pain. IM and IV dosing are more invasive and should not be used unless other methods have failed. Transdermal fentanyl is used for chronic, severe pain in patients tolerant to opioids.

A Patient Newly Diagnosed with Cancer Is Admitted to the Hospital