6: ENT palliative care Flashcards
What is palliative care?
Treatment to improve QOL of patients and their families
Palliative care’s purpose is to (prolong / improve) life.
improve
Which ENT problems require palliative care?
Head and neck cancers
Metastatic cancer
Other diseases in which ENT problems (e.g hearing loss) are a factor
What are red flag symptoms for ENT cancers?
Sore throat > 3 weeks
UNILATERAL PAIN
Hoarseness
Stridor
Dysphagia
Neck lump
The majority of head and neck cancers are ___.
SCCs
squamous cell carcinomas
Which age group develop cancers related to alcohol and smoking?
”” HPV infection?
Older people
Younger people
Are palliative care and “end of life” care the same thing?
No
Palliative care improves QOL and may be given at any time e.g during treatment
End of life care is a type of palliative care
Apart from the hands, which area is most innervated?
What does this mean in terms of palliative care?
Head and neck
Greater capacity to feel pain
Briefly outline the WHO Analgesic Ladder
1. Non-opioid +/- adjuvant
2. Mild opioid +/- non-opioid +/- adjuvant
3. Strong opioid +/- non-opioid +/- adjuvant
Non-opioids: paracetamol, NSAIDs
Mild opioids: codeine
Strong opioids: morphine
Adjuvants: amitriptyline, gabapentin, pregabalin
What is an adjuvant analgesic?
Analgesic whose primary indication isn’t pain
What are the indications for
a) gabapentin, pregabalin
b) amitriptyline?
a) Anticonvulsants
b) Antidepressants
important to explain to patients that these are being given for analgesia and not the above
What are the side-effects of amitriptyline?
Anti-muscarinic effects:
dry mouth
dizziness
postural hypotension
