Palliative Care Flashcards
Treatment of opioid induced constipation
- No cancer
- Cancer
Non- cancer
1) Aperients
2) Prucolapride - 5HT-4 agonist
Cancer
1) Aperients
2) Methlynaltrexone
Opiate conversion - oral
Morphine 30mg
Oxycodone 20mg
Hydromorphone 6mg
Opiate conversion - IV
Morphine 10mg
Oxycodone 10mg
Fentanyl 150mcg
Contraindications/when to rotate to another opioid
Renal failure
Severe liver failure
Unacceptable A/E - hallucinations, sedation, resp changes, myoclonus/jerks
1st line opiate in pal care
Morphine
1st line opiate in suffering delirium with morphine
oxycodone
1st line opiate in terminal phase
hydromorphone
1st line opiate in renal impairement
fentanyl or hydromorph
Pred conversion
5mg pred
20mg hydrocort
25mg cortisone
0.75mg dex