Palliative Care Flashcards
Medication indicated for gastric stasis n/v?
Metoclopramide
Domperidone
S/Sx of gastric stasis related n/v?
Reduced appetite
Epigastric pain
Progressive nausea relieved by vomiting (+/- vomit containing food)
Medication indicated for metabolic / chemical disturbance related n/v?
Haloperidol
Metoclopramide
S/Sx of metabolic / chemical related n/v?
Persistent vomiting
Nausea unrelieved by vomit
Drowsiness
Confusion
Medication indicated for RICP n/v?
Cyclizine
Dexamethasone
S/Sx of RICP related n/v?
Nausea worse in morning
Projectile vomiting
Worse on head movement
Associated headache
Medication indicated for constipation n/v?
Laxatives
e.g. metoclopramide
S/Sx of constipation related n/v?
Nausea
Faeculent vomiting
Abdo distension
Medication indicated for malignant bowel obstruction related n/v?
Cyclizine
Dexamethasone
(Consider CT, stenting, surgery, gastrotomy, NG tube)
S/Sx of malignant bowel obstruction related n/v?
Intermittent vomits (+/- relief of nausea)
Large vol vomits (faeculent / bilious)
Abdo cramping
Altered bowel habit
Abdo distension
Medication indicated for post-operative n/v?
Ondansetron
Describe the WHO analgesic ladder
1 (non-opioid +/- adj) Paracetamol+ NSAIDS
2 (weak opioid +/- adj +/- non-opioid) codeine, tramadol, dihydrocodeine
3 (Strong opioid +/- adj +/- non opioid) morphine, oxycodone, diamorphine, fentanyl, buprenorphine
What is the management of constipation in palliative care?
High fiber / fluid diet
Increase mobility
Stimulants (sodium picosulfate, co-danthramer, senna)
Stool softeners (docusate sodium, glycerol)
Osmotic laxatives (lactulose)
Methylnaltrexone bromide (inhibits SEs of opioids)
