Palliative care and Oncology Flashcards
What type of cancer is superior vena cava obstruction associated with?
small cell lung cancer
What is the favoured pain relief in patients with mild- moderate kidney injury?
oxycodone
How does the dose change going from oral to subcut morphine?
Divide the dose by 2
What markers are useful to assess recurrence of testicular teratoma?
AFP + bHCG
germ cells
How to calculate the breakthrough dose of morphine?
1/10th to 1/6th of the daily dose
repeated every 2-4 hours as required
What is 1st line management for excess mucus secretions in palliative care?
Hyoscine hydrobromide
glycopyrronium bromide
atropine
Monitor for improvements, preferably every 4 hours, but at least every 12 hours.
What is the treatment for hiccups in palliative care?
Chlorpromazine or haloperidol
What is the WHO pain ladder?
Step 1: Paracetamol & NSAIDs
Step 2: Weak opioids –> Codeine, dihydrocodeine, tramadol +- adjuvants
Step 3: Strong opioids–> Morphine, Oxycodone, methadone, bupepinephrine +- adjuvants
What strong opioid is favoured in mild - moderate renal impairment?
Oxycodone
What should be offered if oral strong opioid is not suitable?
subcut delivery
What to prescribe if a person is in end of life care and they are experiencing breathlessness?
- Opioid
- Benzo
- both if symptoms not controlled
only offer O2 if the patient has signs of hypoxia
What to offer someone who is in end of life care and has a bowel obstruction? -
1st line - hyoscine butylbromide
2nd line - octreotide
What anti-emetic is used in raised ICP?
cyclizine
What medication is favoured for pain relief in severe renal impairment?
Fentanyl
Buprenorphine
By what % do you increase morphine dose if the current dose is not helping with pain?
30 -50%
