Palliative Care

Question 1

What anti-emetic is used in reduced gastric motility (related to opioids)?

Answer 1

Metoclopramide or Domperidone

Question 2

What are contraindications to Metoclopramide?

Answer 2

Parkinson’s

GI perforation

Bowel obstruction

Immediately following GI surgery

Question 3

How is nausea and vomiting related to chemotherapy treated?

Answer 3

Ondansetron

Haloperidol

Levomepromazine

Question 4

How is nausea and vomiting related to constipation/candidiasis treated?

Answer 4

Cyclizine or Levomepromazine

Question 5

How is nausea and vomiting relate to raised ICP (often brain mets) treated?

Answer 5

First line = Cyclizine

Also Dexamethasone

Question 6

How is vestibular nausea and vomiting treated?

Answer 6

Cyclizine

Can also use Metoclopramide or prochlorperazine

Question 7

How is nausea and vomiting related to fear or anxiety treated?

Answer 7

First line is PRN Diazepam

Can also try Cyclizine

Question 8

How is agitation and confusion in palliative care treated?

Answer 8

First line = Haloperidol

In terminal stages = Midazolam

Question 9

What drug is used to treat hiccups in palliative care?

Answer 9

Chlorpromazine

Question 10

How much breakthrough morphine should be prescribed?

Answer 10

One sixth of daily dose

Question 11

How do you convert oral codeine to oral morphine?

Answer 11

Divide by 10

Question 12

How do you convert oral morphine to sub cut morphine?

Answer 12

Divide by 2

Question 13

What drugs can be used for respiratory secretions in palliative care?

Answer 13

Hyoscine hydrobromide

Hyoscine butylbromide

Question 14

If pain is not managed in palliative care how much should you increase morphine dose by?

Answer 14

30-50%

Question 15

Which opioids are preferred in CKD?

Answer 15

Buprenorphine/Fentanyl/Alfentanil

Question 16

What can be given for painful mouth in palliative care?

Answer 16

Benzydamine hydrochloride mouthwash