Palliative Care Flashcards
Mx neuropathic pain with glossopharyngeal neuralgia?
Carbamazapine
How to manage an opiod itch?
Opiod switch
or
Add low dose naloxone
How to manage Chemotherapy Biochemical N/V?
Ondansetron
What is the itch with chemotherapy due to?
uraemia and hypercalcaemia
How to manage anxiety and anticipatory N/V?
Alprazolam
How to manage N/V due to ICP?
Dexamethasone
How to mange n/v due to a partial obstruction?
Metoclopramide OR Domperidone (PROKINETIC)
How to manage n/v due to constipation?
Metoclopramide (whilst managing the constipation)
How do you manage n/v due to complete obstruction?
Dexamethasone - reduce tumour oedema
Hyoscine Butylbromide - reduces gastric and intestinal secretions
Consider Surgical stenting
How to do you treat dyspnea due to Pleural Effusion?
- Treat cause: Drain
- Non- Pharm: Position (upright), Fan, relaxation music therapy
- Pharm: Oxygen for Sats <90. 6months funded by PBS regardless of O2 sats.
Beta-agonist if bronchospasm
Nebs Saline: of clear secreion
How do you treat Dyspnea due to Metastasis?
- Treat cause: Palliative radiotherapy
- Non- Pharm: Position (upright), Fan, relaxation music therapy
- Pharm: Oxygen for Sats <90. 6months funded by PBS regardless of O2 sats.
Beta-agonist if bronchospasm
Nebs Saline: of clear secreion
How do you treat Dyspnea due to Pulmonary oedema?
- Diuretics
- Non- Pharm: Position (upright), Fan, relaxation music therapy
- Pharm: Oxygen for Sats <90. 6months funded by PBS regardless of O2 sats.
Beta-agonist if bronchospasm
Nebs Saline: of clear secreion
5 common palliative causes of Itch:
Biliary obstruction Uraemia Malignancy Opiods Skin dryness
Managing itch from skin irritation?
Anti-histamine - promethazine
Managing a cholestatic itch?
Cholestyramine (lowers serum bile acid)
Rifampicin or Setraline
How to manage a malignancy itch?
Cimetidine or Dexa
How to manage a non-specific itch?
Doxepin, Mirtazapine, Paroxetine
How to manage Uraemic itch?
Gabapentin or Pregablin
How to manage sweatign with malignany fever or paraneoplastic syndrome
Try NSAID/Paracetamol
1. Amitriptyline or Dexamethasone
How to manage hot flushes in Breast or prostate cancer?
Venlaxafine or Pregablin
How to manage unknown origin sweating?
Amitriptyline
How to manage malodorous wounds?
Topical Metronidazole
How to manage excessive upper airway secretions in the dying patient?
Glycopyrrolate
How to manage terminal restlessnes and agitation in the dying patient?
Midazolam
How to manage Dyspnea in the dying patient?
Morphine
How to manage N/V in dying patient (Not with parkinson’s)
Metoclopramide
How do you manage Superficial burning pain in Pain in Pall Care?
Antidepressants
How do you manage muscle spams pain?
Diazepam/Clonazepam
How can you manage Anorexia?
Metocloperamide or Corticosteroids
How man you manage Constipation?
Start with Colyxyl and Sienna
Try movicol?
Hyoscine Hybromide can help manage…
Terminal Respiratory Congestion
How can you manage terminal distress and restlessness?
Clonazepam or Midazolam
How can you manage N/V due to morphine?
Haloperidol or prochlorperazine
How can you manage hicoughs?
Chlorpromazine or Haloperidol
