Palliative care and Oncology Flashcards
(17 cards)
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%
What medication can treat Bowel Colic?
hyoscine butylbromide
How to treat vomiting and chemotherapy?
Anticipating –> benzos
During –> Ondansetron
Delayed vomiting–> steroid
