Palliative care

Question 1

First line anti-emetic for raised intracranial pressure/ vestibular

Answer 1

Cyclizine

Question 2

First line anti-emetic for chemo/ toxicity-induced nausea

Answer 2

Ondansetron

Question 3

What are the 4 drug classes included for anticipatory medicines?

Answer 3

• Anti-emetic
• Anxiolytic
• Anti-Secretions
• Analgesia

Question 4

Examples of anti-secretions anticipatory drugs

Answer 4

Hyoceine (Buscipan)

Glycororinium

Question 5

Examples of anxiolytic anticipatory drugs

Answer 5

Haloperidol

Question 6

Examples of anti-emetic anticipatory drugs

Answer 6

Cyclizine

Question 7

______ is the first line anti-emetic for constipation co-morbidity

Answer 7

Metoclopramide

Question 8

______ is the only anti-emetic advised in Parkinson’s disease as it does not cross the blood-brain barrier

Answer 8

Domperidone

Question 9

_________ can be used to provide symptomatic relief for breathlessness

Answer 9

Morphine sulfate

Question 10

First line anti-emetic for gastric stasis/ slow Gi transit

Answer 10

Metoclopramide

Domperiode

Question 11

Legal requirements of advanced decision to refuse treatment (ADRT)

Answer 11

• Must be written down
• Must be carried out when patient has capacity
• Patient must sign it
• Signature must be witnessed

Question 12

What are the 5 key priorities of caring for a dying patient? [5]

Answer 12

Recognise
- Recognise patient can die in hours- days

Communicate
- Communicate to patient and close ones that patient is dying.

Involve
- Involve patient and important close contacts in care and treatment decisions

Support
- Support important patient contacts by exploring, respecting and meeting needs

Plan & Do
- Create individualised plan of care.

Question 13

What antiemetics are indicated first line for opioid induced nausea?

Answer 13

Metoclopramide

Cyclizine, prochlorperazine

Question 14

First line laxatives in palliative care

Answer 14

1. Senna

1. Glycerine suppositories (softens and passes hard stool)

Question 15

What % of malignant diagnosis develop hypercalcaemia

Answer 15

30% (1/3)

Question 16

Non-pharmacological options for shortness of breath

Answer 16

Breathing exercises

Relaxation/ distraction techniques
- Acupressure points

Using a fan

Question 17

Pharmacological management of SoB

Answer 17

Short acting benzo (esp if anixety is present)
- Lorazepam

Low dose opioid

• Morphine
• Oxycodone in renal impairment

Question 18

What medications are prescribed for secretions

Answer 18

Glycopyrronium

Hyoscine hydrobromide

Question 19

First-line medications for agitation at the end of life

Answer 19

Midazolam

Levomepromazine

Question 20

In decompensated HF, fluid should be restricted to…

Answer 20

1.5L max