20 cards Flashcards
Headache caused by raised intracranial pressure due to brain cancer (or metastases) can be palliated with ??
dexamethasone
palliative care for nausea and vomiting that is due to gastric dysmotility and stasis
Dopamine (D2) receptor antagonists s- metoclopramide
good first line anti-emetic for intracranial causes of nausea and vomiting
cyclizine
Metastatic bone pain may respond to?
Analgesia, bisphosphonate therapy, radiotherapy
features of opiod toxicity
reduced conscious level, slow respiratory rate, myoclonic jerks, and pinpoint pupils.
Ring enhancing lesion on head CT =?
bRAIN ABSCESS
first-line to manage secretions in a palliative care setting
?
Hyoscine hydrobromide or hyoscine butylbromide - given SC or by infusion
reducing the discomfort associated with a painful mouth that may occur at the end of life
Benzydamine hydrochloride mouthwash or spray
codiene to morphine conversion
divide by 10
oral to sc morphine conversion
divide 2
analgesia in palliative patients with mild-moderate renal impairment
Oxycodone is preferred to morphine
Tx for phantom limb pain
- Gabapentin - modulates ca channels and reduces central sensitization
Non pharmacological approaches: mirror therapy, graded motor imagery, psychological support
gold standard for detecting spinal mets and evaluating SC compression
MRI of spine
Absolute contraindications to maintenance dialysis
If vascular access can’t be established
Probative CV instability
When should an urgent MRI be considered in mets ca for SC involvement
Only if neurological deficits present/ radiculopathy
Management of dyspnea in end of life care
- PO/ SC PRN morphine - CI: in renal failure as it can accumulate
- PO/ SC PRN hydromorphone - if low rena fx
Initial management for symptomatic pleural effusions in patients with advanced cancer
Therapeutic thoracocentesis - can also differentiate between malignant and cardiac related effusions
