Palliative Flashcards
What can you give to reduce swelling with bony mets?
High dose dexamethasone
Which tranquilizer medication do you use in patients with parkinsons?
Lorazepam (not haloperidol)
What is the first line antipsychotic used in palliative care?
Haloperidol (except in parkinsons)
Which antiemetics are used for intracranial causes of nausea and vomiting?
Cyclizine or dexamethasone
Which antiemetics are prokinetics?
metoclopramide and domperidone
What is the breakthrough dose of morphine?
1/6th of total daily dose
Which opioids are used in renal impairment?
mild-moderate: oxycodone
severe: fentanyl, buprenorphine
What are the eGFR levels for renal impairment?
Mild: 90-60
Moderate: 60-30
Severe: 30-15
renal failure: 15 or less
What is the conversion factor for codeine to morphine?
divide by 10
What is given for a painful mouth in end of life patients?
Benzydamine hydrochloride
What is the conversion of oral to subcut morphine dose?
half
(if diamorphine its 1/3rd)
What can be used to manage metastatic bone pain?
Analgesia, bisphosphonates, radiotherapy
What can be used to to manage hiccups in palliative care?
chlorpromazine or haloperidol
How do you differentiate parkinsons dementia from Lewy body?
In Parkinsons, the motor symptoms occur a year before of the onset of memory symptoms
Which scan is used to diagnose Lewy Body dementia?
SPECT scan
What drugs can be used to manage alzhemiers/lewy body dementia?
acetylcholinesterase inhibitors (Donepazil, rivastigmine) memantine (NMDA receptor antagonist)
What is the definition of multimorbidity?
The presence of two or more long term health conditions
Which score is used to assess pressure ulcers?
Waterlow score
What is the management of a pressure ulcer?
Hydrocolloid dressing, analgesia and nutritional assessment. only give Abx if signs of cellulitis
What are the CT findings in alzheimers dementia?
Widespread cerebral atrophy mainly involving cortex and hippocampus
Which diuretics can precipitate gout?
Thiazide-like diuretics
What are the symptoms of digoxin toxicity?
GI disturbance, dizziness, confusion, blurry vision and arrhythmias
What are the grades for pressure ulcers?
Grade 1 - erythema, intact skin
grade 2 - partial thickness - epidermis/dermis
Grade 3 - into subcut tissue but not through fascia
Grade 4 - directly palpable fascia/bone/muscle
Which tool can be used to assess frailty?
timed up and go, turn 180, PRISMA-7 (age, sex, health problems, mobility)
Which blood tests are done in a confusion screen?
TSH, B12, Folate, Bone profile (calcium), glucose
