Palliative Flashcards
Break through pain relief
1/6th of overall used
How much to increase opioids by
30-50%
Converting codeine to morphine
/10
Converting tramadol to morphine
/10
Converting morphine to oxycodone
/2
PO 30mg morphine to a fentanyl patch
12mcg fentanyl patch
PO 24mg morphine to buprenorphine patch
10 mcg buprenorphine patch
PO morphine to SC morphine
/2
PO morphine to SC diamorphine
/3
PO oxycodone to SC diamorphine
/1.5
Pancreatic cancer pain relief
Can use coeliac plexus block
Gabapentine MOA
Binds to the alpha subunit of voltage gated calcium channels
Anti emetics used in Parkinsons
Cyclizine (can use ondansetron but this can cause constipation)
Aprepriant moa
neurokinin 1 (anti-emetic), inhibits substance P
Lorazepam MOA
GABA A modulator
Baclofen MOA
GABA B modulator
Can steroids cause hallucinations
Yes!
How often should you change a syringe driver
24 hourly
(note should monitor syringe driver site every 4 hours)
Morphine and midazolam can they be in the same syringe driver
Yes
Hypercalcaemia antiemetic of choice
Haloperidol
Intracranial pathology antiemetic of choice
Cyclizine
Chemotherapy antiemetic of choice
Ondansetron is first line, lorazepam is second choice
Oxaliplatin use
Folinic acid and 5-FU used for metastatic colorectal carcinoma
How long does it take for a syringe driver to start working
3-4 hours
Opioid induced constipation management
Senna –> sodium docusate
First line agent in constipation in palliative care
Lactulose
