A 64-year-old man with metastatic prostate cancer and known bony metastases is seen in clinic for constant, deep, aching pain in the low back and both hips, rated 7/10. The pain has not improved despite regular acetaminophen 1000 mg PO q6h. He is receiving androgen deprivation therapy and takes no other analgesics or anticoagulants. He has no history of peptic ulcer disease, and his bowel habit is normal. His goals of care are focused on comfort. On examination there is tenderness over the lumbar spine and iliac crests; lower limb strength, sensation and reflexes are normal. Creatinine 82 µmol/L (60-110), eGFR 88 mL/min/1.73 m² (greater than 60), ALT 24 U/L (10-40), hemoglobin 118 g/L (135-175), platelets 240 x 10^9/L (150-400).
| Heart rate | 80/min |
| Respiratory rate | 16/min |
| Temperature | 36.8 °C |
| O2 saturation | 97%, room air |
| Blood pressure | 128/78 mm Hg |
Question 1 of 39
In addition to continuing acetaminophen, which of the following are the most appropriate medication options at this visit?
Select 2. (0 / 2 selected)
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