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Valget af kraftigt virkende medicin i smertebehandling er en opvejning mellem bivirkninger og virkning samt hvor stærke smerterne er.Male starter oftest den smertestillende behandling med et svagt virkende middel, hvis ikke smerterne allerede er blevet stærke.Den enkelte ekstra dosis er typisk 1/6 af den samlede døgndosis og er frit til rådighe