Palliative care Flashcards
what ONE drug (first line) should you give someone who is bedbound
paracetamol
nothing else will be effective and will probs be in pain (cant communicate it)
second line pain management drug for someone in palliative care (eg bed bound)
weak opioid (eg codeine, co-codamol)
HO pain ladder
first line pain management drug for someone in palliative care
non opioid (eg paracetamol, NSAID)
WHO pain ladder
third line pain management drug for someone in palliative care
strong opioid (eg morphine)
WHO pain ladder
what is co-codamol
codeine and paracetamol
side effects of morphine (3)
resp depression, hallucinations, drowsiness
what happens if you stop morphine suddenly
withdrawal
when increasing the WHO pain ladder from step 2 (codeine) to step 3 (morphine) what must you remember
100mg of codeine = 10mg morphine!!
so start at same dose of pain relief (from above equation) then titre up
what are the 2 types of morphine
MST (PO)
oramorph (PO)
what does MST morphine do
background pain
moderate release drug = lasts all day
how often is MST morphine taken
BDS
what does oramorph (PO morphine) do
relieves ‘breakthrough’ pain
how often is oramorph (PO morphine) taken
PRN
if after a few days someone is taking MST morphine BDS AND lots of oramorph, what do you do
calculate the total morphine being taken and give all of this MST - so that only small amounts of oramorph are used
what happens to MST Po morphine when patient can no longer swallow
given through a syringe driver (SC)
