Other Symptoms

Question 1

What symptoms may you see in someone who is dying?

Answer 1

1. Nausea and vomiting
2. Constipation
3. Insomnia
4. Pruritus
5. Intractable hiccups

Question 2

How might you treat nausea and vomiting in palliative care?

Answer 2

Anti-emetic (not ondansetron as it causes constipation)

Question 3

How might you treat constipation in palliative care?

Answer 3

Stimulant laxative (Senna) at night +/- softener (Sodium docusate)

Question 4

How might you manage insomnia in palliative care?

Answer 4

1. Appropriate room temperature, darkness, quiet during night.
2. Discuss and address psychosocial issues.
3. Zopiclone may be used in some cases.

Question 5

How might you manage pruritus in palliative care?

Answer 5

1. Cholestasis consider biliary stenting

2. Opioid induced - use antihistamine

Question 6

How might you treat intractable hiccups in palliative care?

Answer 6

Chlorpromazine