Palliative Care

Question 1

Mx neuropathic pain with glossopharyngeal neuralgia?

Answer 1

Carbamazapine

Question 2

How to manage an opiod itch?

Answer 2

Opiod switch
or
Add low dose naloxone

Question 3

How to manage Chemotherapy Biochemical N/V?

Answer 3

Ondansetron

Question 4

What is the itch with chemotherapy due to?

Answer 4

uraemia and hypercalcaemia

Question 5

How to manage anxiety and anticipatory N/V?

Answer 5

Alprazolam

Question 6

How to manage N/V due to ICP?

Answer 6

Dexamethasone

Question 7

How to mange n/v due to a partial obstruction?

Answer 7

Metoclopramide OR Domperidone (PROKINETIC)

Question 8

How to manage n/v due to constipation?

Answer 8

Metoclopramide (whilst managing the constipation)

Question 9

How do you manage n/v due to complete obstruction?

Answer 9

Dexamethasone - reduce tumour oedema
Hyoscine Butylbromide - reduces gastric and intestinal secretions

Consider Surgical stenting

Question 10

How to do you treat dyspnea due to Pleural Effusion?

Answer 10

1. Treat cause: Drain
2. Non- Pharm: Position (upright), Fan, relaxation music therapy
3. Pharm: Oxygen for Sats <90. 6months funded by PBS regardless of O2 sats.
   Beta-agonist if bronchospasm
   Nebs Saline: of clear secreion

Question 11

How do you treat Dyspnea due to Metastasis?

Answer 11

1. Treat cause: Palliative radiotherapy
2. Non- Pharm: Position (upright), Fan, relaxation music therapy
3. Pharm: Oxygen for Sats <90. 6months funded by PBS regardless of O2 sats.
   Beta-agonist if bronchospasm
   Nebs Saline: of clear secreion

Question 12

How do you treat Dyspnea due to Pulmonary oedema?

Answer 12

1. Diuretics
2. Non- Pharm: Position (upright), Fan, relaxation music therapy
3. Pharm: Oxygen for Sats <90. 6months funded by PBS regardless of O2 sats.
   Beta-agonist if bronchospasm
   Nebs Saline: of clear secreion

Question 13

5 common palliative causes of Itch:

Answer 13

Biliary obstruction
Uraemia
Malignancy
Opiods
Skin dryness

Question 14

Managing itch from skin irritation?

Answer 14

Anti-histamine - promethazine

Question 15

Managing a cholestatic itch?

Answer 15

Cholestyramine (lowers serum bile acid)

Rifampicin or Setraline

Question 16

How to manage a malignancy itch?

Answer 16

Cimetidine or Dexa

Question 17

How to manage a non-specific itch?

Answer 17

Doxepin, Mirtazapine, Paroxetine

Question 18

How to manage Uraemic itch?

Answer 18

Gabapentin or Pregablin

Question 19

How to manage sweatign with malignany fever or paraneoplastic syndrome

Answer 19

Try NSAID/Paracetamol

1. Amitriptyline or Dexamethasone

Question 20

How to manage hot flushes in Breast or prostate cancer?

Answer 20

Venlaxafine or Pregablin

Question 21

How to manage unknown origin sweating?

Answer 21

Amitriptyline

Question 22

How to manage malodorous wounds?

Answer 22

Topical Metronidazole

Question 23

How to manage excessive upper airway secretions in the dying patient?

Answer 23

Glycopyrrolate

Question 24

How to manage terminal restlessnes and agitation in the dying patient?

Answer 24

Midazolam

Question 25

How to manage Dyspnea in the dying patient?

Answer 25

Morphine

Question 26

How to manage N/V in dying patient (Not with parkinson’s)

Answer 26

Metoclopramide

Question 27

How do you manage Superficial burning pain in Pain in Pall Care?

Answer 27

Antidepressants

Question 28

How do you manage muscle spams pain?

Answer 28

Diazepam/Clonazepam

Question 29

How can you manage Anorexia?

Answer 29

Metocloperamide or Corticosteroids

Question 30

How man you manage Constipation?

Answer 30

Start with Colyxyl and Sienna

Try movicol?

Question 31

Hyoscine Hybromide can help manage…

Answer 31

Terminal Respiratory Congestion

Question 32

How can you manage terminal distress and restlessness?

Answer 32

Clonazepam or Midazolam

Question 33

How can you manage N/V due to morphine?

Answer 33

Haloperidol or prochlorperazine

Question 34

How can you manage hicoughs?

Answer 34

Chlorpromazine or Haloperidol