Palliative Care Flashcards
How do you take a pain history?
Site
Onset
Character
Radiation
Associated features
Time
Exacerbating factors
Severity
What are the pain sources of pain in cancer?
Spinal cord compression
Liver capsule pain
Colic
State the two key types of pain
Nociceptive
Neuropathic
Describe the analgesic ladder
- Mild pain - paracetamol/NSAID
- Moderate pain - weak opioid
- Severe pain - strong opioid
What are the two types of release?
Immediate release
Slow/modified release
How do you calculate the breakthrough dose?
1/6th of 24 hour dose
What must be prescribed with an opioid?
Antiemetic
Laxative
How do you convert an oral dose to subcutaneous?
Divide the oral dose by 2
If a patient has renal impairment what opioids are recommended?
Mild - oxycodone
Severe - buprenorphine/alfentanil/fentanyl
What are the signs of opioid toxicity?
Persistent sedation
Vivid dreams/hallucinations
Delirium
Muscle twitching/jerking
Abnormal skin sensitivity
What is in a Just in Case bundle?
Pain - morphine
Distress - midazolam
Nausea - levomepromazine
Respiratory secretions - hyosine butylbromide
What can be given for neuropathic pain?
Gabapentin
Pregabalin
Amitriptyline
How can hiccups be managed?
Chlorpromazine
Haloperidol
Gabapentin
Dexamethosone if hepatic lesions
Describe the components of REDMAP
Ready
Expect
Diagnosis
Matters
Action
Plan
