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Y4 Gen Med > Palliative Care > Flashcards

Palliative Care Flashcards

1
Q

Which is the first line strong opioid?

A

Which is the first line strong opioid?

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2
Q

What is a CI to morphine?

A

Stage 4/5 renal impairment

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3
Q

Is oromorph short or long acting?

A

Short-acting

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4
Q

What is the name of long acting morphine?

A

MST

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5
Q

What should always be co-prescribed with morphine?

A

Laxative + antiemetic

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6
Q

How does opiate toxicity present?

A

Miosis, confusion, delirium, reduced consciousness, myoclonus, vivid dreams, hallucinations, cold/ clammy, gurgling sounds, blue lips/ finger tips

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7
Q

What are the four anticipatory medications? Include doses

A

Secretions – buscopan hyoscine butylbromide 20mg SUBCUT
Nausea – levomepromazine 2.5mg SUBCUT
Distress – midazolam 2mg SUBCUT
Pain - opioid

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8
Q

How do you calculate oral breakthrough opioid dose?

A

1/6 of total daily dose

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9
Q

Which opioids are better in renal impairment?

A

Oxycodone (breakthrough) and fentanyl

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10
Q

What is the max daily dose of codeine?

A

240mg

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11
Q

How do you convert morphine dose to oxycodone?

A

Divided by 2

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12
Q

How do you convert oral to subcut morphine dose?

A

Divide oral dose by 2

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13
Q

Convert 35mg BD oral morphine to SUBCUT

A 
35mg SUBCUT 
(Half of total daily dose)
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14
Q

How do you convert codeine into morphine dose?

A

Times total daily dose by 10

eg 60 mg codeine QDS = 24mg morphine in 24hr

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15
Q

How do you convert tramadol into morphine dose?

A

Times total daily dose by 10

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16
Q

How do you increase the dose of morphine?

A

Count breakthrough doses in 24hr and add to MST dose = this should become the total daily MST dose
(should not exceed 30-50% increase)

17
Q

How do you convert oral morphine to SC morphine?

A

Divide by 2

18
Q

How do you convert oral morphine to oral oxycodone? What about to SC oxycodone

A

To oral divide by 2

To SC divide by 4

Y4 Gen Med (9 decks)

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