N+V palliative care

Question 1

What simple measures may help nausea and vomiting in palliative care?

Answer 1

Make sure the person has access to a large bowl, tissues, and water.
The sight and smell of food or drink may provoke nausea
Make sure that meals are small and palatable — snacks consisting of a few mouthfuls are less challenging than big meals
Carbohydrate meals are often better tolerated
Offer cool, fizzy drinks (citrus flavours are often preferred) — these are more palatable than still or hot drinks
Consider the use of complementary therapies; relaxation and acupressure bands may be useful to relieve symptoms.
Consider cognitive behavioural therapy for anticipatory nausea or vomiting
In general, avoid nasogastric suction It has no role in the management of most causes of nausea and vomiting

Question 2

True or false - give cold fizzy drinks

Answer 2

True

Question 3

this drug is commonly used for most chemical causes of vomiting (such as hypercalcaemia, morphine use, and renal failure).

Answer 3

Haloperidol

Question 4

this is commonly used for nausea and vomiting due to raised intracranial pressure (in conjunction with dexamethasone), and/or vestibular dysfunction.

Answer 4

cyclizine

Question 5

name a BS antiemetic

Answer 5

levomepromazine

Question 6

what are commonly used for nausea and vomiting associated with gastritis, gastric stasis, and functional bowel obstruction, because of their prokinetic action.

Answer 6

metoclop
alt domperidone

Drugs with antimuscarinic effects antagonise prokinetic drugs and, if possible, should not be used concurrently.