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4th year passmed > Palliative and Geriatric medicine > Flashcards

Palliative and Geriatric medicine Flashcards

1
Q

How do you convert from oral to subcutaneous morphine dosing?

A

Divide by 2

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2
Q

What is a standard dosing of morphine for patients with progressive disease and no comorbidities?

A

15mg MR morphine PO BD

5mg Oromorph PO PRN

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3
Q

How much should the dose of opioids be increased by in thesubsequent dose?

A

30-50%

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4
Q

What is the conversion factor from codeine to morphine to tramadol?

A

x10 x10

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5
Q

WHat is the conversion factor from oral mophine to diamorphine?

A

Divide by 3

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6
Q

What is the first choice of prescription for agitation and confusion in a pre-terminal and terminal patient?

A

Pre terminal - Haloperidol PO

Terminal - Midazolam SC

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7
Q

What interventions does metastatic bone pain typically respond to?

A

Strong opioids
Bisphosphonates
Radiotherapy

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8
Q

What is the difference in side effect profile between oxycodone and morphine?

A

Oxycodone causes less sedation, vomiting and pruritis but more constipation

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9
Q

How much of the daily dose should the breakthrough dose of morphine be?

A

1/6th

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10
Q

How much morphine is 12mcg/hr fentanyl patch equivalent to?

A

30mg daily

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11
Q

What opioids are safest for use in patients with severe renal impairment?

A

Fental and buprenorphine - as they are not renally excreted

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12
Q

What medications can be used for hiccups in palliative care?

A

Chlorpromazine

Haloperidol

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13
Q

What should be added to the syringe driver in a patient with malignant bowel obstruction?

A

Hyoscine butylbromide

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14
Q

What is the mechanism of action of Donepezil?

A

Acetylcholinesterase inhibitor

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15
Q

Which antipsychotic is contraindicated in PD patients>

A

Haloperidol

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16
Q

What is the MOA of memantine?

A

NMDA antagonist

17
Q

Aside from routine bloods, what blood tests are included in a confusion screen?

A

Vit B, folate
TFTs
Glucose
Bone profile

18
Q

What scoring system assesses a patients risk of developing a pressure sore?

A

Waterlow score

19
Q

What medication should be considered in a delerious patient with Parkinson’s disease?

A

Lorazepam

20
Q

What is the typical presentation of hypoactive delerium?

A

Withdrawal, lethargy and slowness to respond

4th year passmed (28 decks)

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