Loros Flashcards
How to calculate morphine PRN
Total daily dose/6
How often can someone have PRN morphine
Hourly
Max 6 in 24 hours
How to convert oral morphine to subcutaneous
Divide total daily dose by 2
Oral morphine to oral codeine conversion
1:10
Morphine to diamorphine
Divide by 2
When should cyclizine be used
N+V in
Bowel obstruction
Raised ICP - brain mets
When should antihistamines be used for N+V
Vertigo, menieres, pregnancy, motion sickness, post Op
Cyclizine contraindicated
Heart failure
How do anti-histamines including cyclizine work for N+V
Act on H1 receptor which in turn act on vestibular system ant CTZ
When should metoclopramide be used for N+V
Delayed gastric emptying
Constipation
Chemo/ radiotherapy induced N+V
Metoclopramide contraindications
Bowel obstruction- Inc risk perforation
Parkinson’s disease
Levopromazine and haloperidol N+V indications
Hypercalcaemia
Hyponatraemia
Dopamine antagonists (Metoclopramide, domperidone) mechanism of action
Act on D2 receptors in CTZ
Why use levomepromazine
Good in palliative care, B-road spectrum so acts on multiple receptor sites therefore covers multiple aetiologies of N+V.
Secondary effect as a sedative
Indications for ondansetron
Chemo
Post Op
Parkinson’s
Acute gastroenteritis
