5: Ageing and end of life care Flashcards
http://www.palliativecareguidelines.scot.nhs.uk/
WHO pain ladder
opioid withdrawal & naloxone
morphine dose for breakthrough pain is 1/6 of the background dose
to convert codeine dose to morphine dose, divide by 10
because morphine is 10x stronger
look at calculations
key information summary contains patient’s wishes in the event of deterioration
death mimics:
opioid overdose
sepsis
hypercalcaemia
acute kidney injury
hypo
syringe driver
pump for continous subcutaneous infusion of drugs - pain management, secretions etc.
subcutaneous morphine is twice as potent as other routes
so half dose for syringe drivers
buscopan (hyoscine butylbromide) used to reduce respiratory secretions
morphine for pain
midalozam (class?) for distress
levomepromazine for nausea
myoclonus, hallucinations, vivid dreams –> opioid toxicity