Palliative care Flashcards
What are the characteristics of bone pain?
DULL over large area or well localised tenderness over a bone
Worse on weight bearing/movement
What is the best medication/treatment for bone pain? (3)
1) NSAIDs (diclofenac)
2) Bisphosphonates - for osteroporotic related pain or sclerotic bone mets
3) Radiotherpay
What are the characteristics of visceral pain?
Dull, deep seated, poor localised pain
May be localised over a specific organ
Spasmodic pain in bladder/colon
What is the best medication for collicky pain?
Anti spasmodics e.g. hyocine butylbromide
What is the best medication for bladder spasm?
Oxybutinin
What is the best medcation for general visceral pain?
Follow pain ladder
Consider NSAIDs or corticosteroids if suspect inflammation
What is oprpresive pain worse on waking, coughing , sneezing and associated with nausea and vomiting suggestive off? What treatment should be given?
Corticosteroids to reduce oedema
16mg Dexamethasone
NSAIDs and paracetamol
What are the characteristics of neuropathic pain?
Pins and needles
Burning
Abnormal sensation - numbness. hyperaesthesia
Autonomic changes in area - pallor, seating
What is the the best treatment for neuropathic pain?
Amitryptiline
Pregabalin/Gabapentin
What is the treatment for xerostomia/oral thrush?
- Treat thrush wih nystatin or fluconazole
2. Fluid swab
What treatment can you give for anorexia symptoms?
Try and reverse cause first
Dexamethasone (effect wears off)
Megesterol acetate (effective for longer but causes fluid retention)
What are the features of gastric stasis/irritation N+V?
Early satiety and epigastric fullness
Nausea decreased after vomit
Minimal nausea between vomiting
What is the treatment of gastric stasis/gastric irritation N+V?
Metoclopramide
consider PPI if gastric irritation
What are the characteristics of toxic N+V?
Contant nausea
Small vomits - possets
Wretching
What is the treatment for toxic N+V?
Haloperidol
