A 60-year-old patient diagnosed with breast neoplasia 10 years ago. She underwent treatment with radiochemotherapy and then hormonal therapy for 5 years. A bone scan study performed for polytopic bone pain showed the presence of bone metastases. She is currently under treatment with minor opioids and NSAIDs with good pain control. She consulted for headache that did not subside with the current analgesia and a CT scan of the brain showed images compatible with brain metastases. In relation to the treatment of pain, indicate the CORRECT one:
Brain metastases produce pain due to cranial hypertension. The treatment of choice is corticosteroids. Dexamethasone in oral doses of 4 to 16 mg/day is the treatment of choice.
Switch to major opioids.
Extra doses of opioids should be administered as necessary.
Corticoids should be added.
Switch to a major opioid and maintain NSAIDs.
The patient should be admitted for intravenous treatment with major opioid.
Brain metastases produce pain due to cranial hypertension. The treatment of choice is corticosteroids.