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ICSM Year 6 COPY Helen Lashwood > Medicine - Palliative > Flashcards

Medicine - Palliative Flashcards

1
Q

What is the most common side effect of cyclophosphamide?

A

Haemorrhagic cystitis

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2
Q

What are the toxicities of cisplatin?

A

Ototoxic, nephrotoxic, hypomagnasaemia

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3
Q

Which chemotherapy agent is associated with SIADH?

A

Cyclophosphamide

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4
Q

What is the starting dose of morphine in palliative care?

A

15mg morphine MR PO BD
5mg oromorph IR PO PRN
Can start with IR and then when pain controlled –> MR

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5
Q

What is the most common side effect of MR morphine?

A

Nausea

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6
Q

What opioid is best to use for palliative patients with a GFR of 30-60?

A

Oxycodone

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7
Q

What opioids are best to use for palliative patients with a GFR of <30?

A

Fentanyl
Buprenorphine

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8
Q

How much should a breakthrough dose of morphine be?

A

1/6th of total morphine

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9
Q

100mg codeine is equivalent of how many mg of morphine?

A

10mg

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10
Q

What is the equivalent of 30mg IR morphine in a MR formulation?

A

15mg
prescribe half when doing MR

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11
Q

Recall 3 ways in which bony met pain can be managed

A
  1. Analgesia
  2. Bisphosphonates
  3. Radiotherapy
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12
Q

Which anti-emetic is usually prescribed in palliative care?

A

Cyclizine

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13
Q

What is the usual dose of cyclizine in palliative care?

A

50mg 8-hourly

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14
Q

In what patients is it inappropriate to prescribe cyclizine and why?

A

Cardiac cases
Can worsen fluid retention

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15
Q

Recall 2 patient groups in which metoclopramide should be avoided

A

Parkinson’s disease
Young women (risk of dyskinesia)

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16
Q

What is the anti-emetic of choice in Parkinson’s?

A

Domperidone

17
Q

What is the drug of choice for agitation in palliative care vs for terminal restlessness?

A

Agitation in palliative pts: haloperidol (and correct underlying cause)
Terminal restlessness: midazolam

18
Q

Recall the 1st and 2nd line drugs used for secretions in palliative care

A
  1. Hyoscine hydrobromide
  2. Glycopyrronium bromide
19
Q

What is the first line for treating hiccups in palliative care?

A

Chlorpromazine

20
Q

In a patient with cord compression due to spinal mets who is too frail for surgery, what is the treatment of choice?

A

External beam radiotherapy

21
Q

What is the anti-emetic of choice for patients with chemo/radio-associated nausea?

A

Ondansetron + dexamethosone

22
Q

What is the antiemetic of choice in palliative care for for nausea and vomiting that is due to gastric dysmotility and stasis?

A

Metoclopramide

ICSM Year 6 COPY Helen Lashwood (20 decks)

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