Common palliative care symptoms

Question 1

What is the management of pain in opioid naive?

Answer 1

Morphine subcut 2mg hourly PRN

Question 2

What is the breakthrough analgesia on syringe driver?

Answer 2

1/6th total daily dose

Question 3

What is the presentation of terminal secretions?

Answer 3

Rattily breathing due to build up of secretions the patient is too weak to clear

Question 4

What is the management of terminal secretions?

Answer 4

Hyoscine butylbromide 20mg PRN

Question 5

What is the management of agitation?

Answer 5

Midazolam 2mg

Question 6

What is the management of terminal and severe agitation?

Answer 6

Levomepromazine

Question 7

What is the management of breathlessness?

Answer 7

Midazolam 2mg- decreases agitation associated with breathlessness
Morphine 2mg- depresses respiratory drive and lessens feeling of breathlessness

Question 8

What is the management of terminal nausea?

Answer 8

Levomepromazine 2.5mg

Question 9

How much should opioid doses be increased by?

Answer 9

30-50%

Question 10

What is the conversion between codeine and morphine?

Answer 10

Divide by 10

Question 11

What is the conversion from oral to subcut morphine?

Answer 11

Divide by 2