geris

Question 1

meds to avoid in Lewy body dementia

Answer 1

neuroleptics - HARM
Haloperidol
Antipsychotics
pRochlorperazine
Metoclopramide

Question 2

which bloods are included in a ‘confusion screen’

Answer 2

vitamin B12
folate
bone profile
glucose
TFTs

Question 3

which meds are used for mild-moderate Alzheimer’s

Answer 3

AChE inhibitors: donepezil, galantamine, rivastigmine

NMDA receptor antagonist: memantine (if AChE inhibitors CI/intolerant)

Question 4

when can postural hypotension be diagnosed

Answer 4

drop in SBP of >=20 mmHg +/- symptoms
drop to SBP <90 mmHg on standing, even if drop is <20mmHg +/- symptoms
drop in DBP of 10 mmHg w symptoms

Question 5

mx for agitation/confusion in palliative care

Answer 5

1. Oral Haloperidol

2. SC Midazolam

Question 6

mx for oral pain in palliative care

Answer 6

benzydamine mouthwash

Question 7

oral morphine to SC morphine

Answer 7

divide oral morphine dose by 2

Question 8

oral morphine to SC diamorphine

Answer 8

divide oral morphine dose by 3

Question 9

standard dose timing for breakthrough pain relief

Answer 9

2-4 hourly

Question 10

best palliative pain relief for renal impairment

Answer 10

mild-moderate - oxycodone

severe - buprenorphine, fentanyl or alfentanil