Palliative Care Flashcards
1
Q
Symptoms for palliative intervention?
A
- fatigue
- weakness
- pain
- breathlessness
- poor appetite
- dry mouth
- nausea
- anxiety
2
Q
Explain the opioid ladder
A
- simple analgesia (NSAIDs, paracetamol, aspirin)
- weak opioid (codeine, tramadol)
- strong opioid (morphine, oxycodone, fentanyl)
3
Q
Prescribing morphine?
A
- slow release (lasts 12hrs, twice daily)
- immediate release morphine (lasts 4hrs, PRN, Breakthrough dose, 1/6th of daily dose)
4
Q
Signs of opioid toxicity?
A
- hallucinations
- myoclonus
- drowsiness
- renal failure = opioid build up
- respiratory depression
5
Q
Potential contraindication of morphine or oxycodone?
A
- renally excreted
- renal failure contraindicated (consider fentanyl)
6
Q
What can be used to reverse opioid?
A
- naloxone
7
Q
Role of syringe drivers?
A
- oral route for drugs not possible
- infused over 24hrs
8
Q
Difference between oral and SCUT morphine?
A
- SCUT (subcutaneous via syringe) is twice as strong as oral
- divide oral / 2
9
Q
Palliative prescribing for pain?
A
- morphine 2mg hrly SCUT
10
Q
Palliative prescribing for SOB?
A
- Morphine 2mg SCUT hrly
11
Q
Palliative prescribing for distress?
A
- midazolam 2mg SCUT hrly
12
Q
Nausea palliative prescribing?
A
- levomepromazine 2.5mg 12hrly
13
Q
Palliative prescribing for secretions?
A
- buscopan 20mg scut hrly
