Ageing deck 3 Flashcards
What drugs can you use for the control of mild pain in the elderly?
Paracetamol
And/or NSAID
What drugs can you use for the control of moderate pain in the elderly?
Codeine
What drugs can you use for the control of severe pain in the elderly?
Stop codeine, switch to morphine.
Can use in conjunction with paracetamol/NSAID/adjuvants
What must you consider when taking a patient off of morphine?
If established on morphine, will get opioid tolerant and get withdrawal if suddenly stopped
What is a severe side effect of morphine?
Respiratory depression
What drug can quickly reverse morphine?
Naloxone
What are the symptoms of opioid toxicity?
Hallucinations
Myoclonus
Drowsiness
What is myoclonus?
Spasmodic jerky contraction of a group of muscles
What are the 2 types of morphine currently available?
Modified release
Immediate release
What might be some signs/symptoms that a person is dying?
Weakness
Losing interest in flood/fluid
Sleeping more
Patients nearing the end of life often struggle with oral meds. How can we overcome this?
Syringe driver (constant s/c infusion)
stop all unnecessary meds e.g. statins
What is given to dying patients to stop pain?
Morphine
What is given to dying patients to stop distress?
Midazolam
What is given to patients to avoid nausea?
Levomepromaxine
What is given to patients to help with secretions?
Buscopan
How do you verify death?
Check for spontaneous movement (including resp effort)
Check for reaction to voice and pain
Palpate 2 major pulses for 1 min
Inspect the eyes
Auscultate the heart and lungs for 1min
Note if pacemaker or other implantable device present
Record date and time of death in notes
What do you look for in the eyes to verify death?
Dryness
Fixed dilated pupils
Absence of corneal reflexes
Clouding of cornea
