Palliative Care Flashcards
name step 1 of the pain ladder
paracetamol 1g 4x daily
and/or NSAID 500mg 2x daily
name step 2 of the pain ladder
codeine 30-60mg 4x daily
OR co-codamol 30/500 2 tabs 4x daily
name step 3 of the pain ladder
stop codeine and switch to morphine
can add paracetamol/NSAID
how should morphine be stopped?
very slowly to prevent withdrawal
name symptoms of opioid toxicity
hallucinations
myoclonus
drowsiness
name the 2 types of morphine
modified release
immediate release
which type of morphine is used for breakthrough severe pain?
immediate release
which type of morphine is taken PRN?
immediate release
how often is MR morphine taken?
2x daily
is oramorph IR or MR?
IR
how do you work out the dose of morphine in a patient who is already on codeine?
divide the total codeine dose by 10 eg (60mg codeine 4x pd = 240mg, divide by 10 to get 24mg morphine)
if a patient is on 50mg codeine 4x a day, what should be their morphine dose
20mg
what treatable conditions can mimic dying?
sepsis
hypo/hyperglycaemia
AKI
drug toxicity
anticoagulants and statins should be continued in end of life care T or F
T
how should drugs be given to someone in palliative care
subcutaneously via a syringe driver
NOT ORALLY
