23: MAiD Flashcards
MAiD provision has _______ in Alberta
increased
what age group has the highest usage of MAiD?
78-80yrs
what is the main condition for which people apply for MAiD
cancer
4 steps of MAiD process
pt’s request
pt assessment (2)
eligibility
provision (planning, schedule day)
describe the general IV MAiD protocol
anxiolytic → opioid (optional PRN pain)→ local anesthetic → coma inducing → neuromuscular blocker
what drugs are used in the IV MAiD protocol
Midazolam 2.5-10 mg 2min → fentanyl 25-500mcg 1-2min → lidocaine 40 mg 30s → propofol 1g 5min → rocuronium
T or F: order of drug admin doesn’t matter in MAiD delivery
F- Order of administration important as some meds are unpleasant and site irritating (burns) - may give lido to decrease
T or F: if a patient passes during MAiD protocol, you do not need to finish administration of all drugs
F- still finish
3 pros of IV MAiD protocol
Prevents some complications (ex - due to emesis)
No bioavailability issues
Clinician present to tx SEs and complications
3 cons of IV MAiD protocol
Less pt autonomy
Requires IV access- greater intervention
Clinician requires greater skill for IV access and med admin
describe the steps in PO MAiD protocol
Gastric motility/ antiemetic → anxiolytic → coma inducing
what drugs are used in the PO MAiD process
Haloperidol 2mg 1hr pre ingestion → lorazepam 0.25-0.5mg → DDMP2 1-2min
what 4 sx may need management in PO MAiD
emesis
respiratory depression
seizures
pain or distrses
5 pros of PO MAiD
Autonomy
Less medicalized
Not invasive, no IVs, etc
Admin at home or favorite location
Locus of control- can save med until things get really bad
4 cons of PO MAiD
Requires ability to self administer
Associated with complications (delayed onset, pt doesn’t take as intended, N/V, etc)
May not be able to administer
May require clinical presence, IV back up
which of the following is a major barrier for MAiD
1. patients often want more control
2. there is not a lot of research about the most efficacious way to use drugs for MAiD
3. complications are common in both IV and PO MAiD protocols, requiring back ups
4. protocol lacks standardization for PO process
2
T or F: the pharmacist may be involved in the MAiD consent process
F
what are 3 pharmacist responsibilities in MAiD
medication supply
teamwork
documentation
in “A Hospital Pharmacist’s Experience with MAiD- A Qualitative Study”
1. many participants experienced MAiD in a similar way
2. participants found themselves distancing themselves and personal lives from the MAiD experience
3. Pharmacists mainly experienced medication focused roles
4. Participants found that limiting emotion was best to carry out the process
5. none of the above
5
Each participant experienced MAiD practiced in a unique way
Participants viewed MAiD and their role in relation to themselves, the pts, the pharmacy and HC teams, and their family, friends, and community
Roles in MAiD were primarily med focused, yet experienced as a caring role
Experiences in MAiD involved a range of emotions
