Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

PHAR 557 > Palliative Care > Flashcards

Palliative Care Flashcards

1
Q

What’s the goal of palliative care?

A

Relieve suffering (pain and other physical, psychological, spiritual problems)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

T or F: Palliative care aims to hasten death.

A

F

It doesn’t intend to hasten nor postpone death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Who is palliative care for?

A

ANY pt w/ a chronic, life-limiting illness or tx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Who will most likely receive palliative care?

A

pts w/ advanced terminal illnesses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

T or F: Palliative care is only for cancer pts

A

F

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

T or F: Palliative care is only for pts who are imminently dying

A

F

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What’s the main diff b/w palliative care units and hospices?

A

Hospices are for palliative pts w/ STABLE probs

Palliative care units are for palliative care pts w/ acute or difficult-to-tx problems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What type of pts are most likely to receive palliative care?

A

Cancer pts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What kind of drug coverage is available for palliative pts?

A

Palliative Care Drug Coverage > covers 100% of Rx’ed drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Main drug used by those on palliative drug plans?

A

Opioids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What’re the three main trajectories of decline at the end of life?

A

Cancer, organ failure, and physical/cognitive frailty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Describe the functional trajectory of cancer patients

A

These pts have a high level of functioning throughout their lives until they near their death, where they have a sudden decline in functionality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Most common sx in cancer pts

A

Pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

T or F: Most cancer pts do not have satisfactory relief of their pain.

A

F

90% DO get relief from their pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Goal of palliative pain mgmt?

A

Comfort

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Palliative pain mgmt is managed mainly by…

A

opioids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What parenteral route is used for palliative pain mgmt?

A

subcutaneous butterfly route

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

T or F: Multiple drugs can be injected into the same butterfly subcut lne.

A

F (one line per medication)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What assessment algorithm is used to initially assess pain?

A

OPQRST

onset
palliation/provocation (what makes it better/worse?)
quality (nociceptive vs neuropathic)
radiation/region (does it travel? where is it located?)
severity
temporal (how long does it last? any particular time it gets worse/better? how long does med cause relief for?)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the analgesic ladder?

A

The medications recommended for persistent/increasing amts of pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

List the meds recommended on the analgesic ladder, starting with the lowest potency ones

A
  1. non-opioids (tylenol, NSAIDs +/- adjuvant)
  2. Opioids for mild-moderate pain (codeine, oxycodone, tramadol +/- adjuvant)
  3. Opioids for mod-severe pain (morphine, oxycodone, hydromorphone, fentanyl, methadone +/- adjuvant)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What’s an adjuvant wrt analgesic tx for palliative pts?

A

Agents used for neuropathic pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What additional medication should be taken with opioids?

A

constipation meds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

T or F: Opioid-induced constipation eventually goes away

A

F

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
T or F: Opioid-induced sedation eventually goes away
T (after 2-4d)
26
Opioid AEs:
N/V, constipation, sedation, delirium/confusion/hallucinations, pruritus, dry mouth, urinary retention, resp dep, myoclonus, hyperalgesia and allodynia
27
Opioid-induced pruritus is caused by...
histamine release
28
T or F: N/V are not common in advanced stages of cancer
F
29
What is used for: opioid-induced N/V that stimulates DA receptors in the CTZ?
D2 antagonist
30
What is used for: opioid-induced N/V that is the result of slow GI transit?
prokinetic agents (domperidone or metoclopramide)
31
What is used for: opioid-induced N/V that is the result of increased sensitivity of the vestibular apparatus?
antiH's, antichols
32
N/V mediated by the chemoreceptors and mechanoreceptors of the GIT - what're the NTs and receptors involved?
5-HT3, D2, and opioid receptors
33
N/V mediated by the CTZ - what're the NTs and receptors invovled?
D2, 5-HT3, H1, ACh
34
N/V mediated by the cerebral cortex - what're the NTs and receptors involved?
GABA
35
N/V mediated by the vestibular apparatus - what're the NTs and receptors involved?
H1 and ACh
36
List D2 antagonists used for N/V.
metoclopramide, domperidone, haloperidol, methotrimprazine, prochlorperazine
37
List 5-HT3 antagonists for N/V.
ondansetron, granisetron
38
List histamine blockers for N/V (antihistamine).
dimenhydrinate
39
What steroid is used for tx'ing N/V?
dexamethasone
40
First line for opioid-induced N/V?
Metoclopramide > both a D2 antagonist and prokinetic
41
CI of metoclopramide?
Complete bowel obstruction
42
Why does domperidone have less risk of EPS relative to metoclopramide?
Bc it does NOT cross the BBB
43
If you want a broader spectrum D2 antagonists and prokinetic, would you use domperidone or metoclopramide? Why?
Metoclopramide since it crosses the BBB
44
1st line for N due to malignant bowel obstruction?
Haloperidol
45
This medication is good for most types of N
Methotrimeprazine
46
Why is methotrimeprazine good for most types of N?
It is an antagonist for D2, 5-HT2, H1, and ACh
47
1st line for chemotx/radiotx-induced N.
Ondansetron/Granistron
48
MOA of ondansetron/granistron?
5-HT3 antagonist
49
1st line for anticipatory or anxiety-related N?
BZDs
50
1st line for motion-induced nausea?
dimenhydrinate (Gravol)
51
MOA of dimenhydrinate?
H1 antagonist
52
T or F: dimenhydrinate is useful for opioid-induced nausea
F
53
Dimenhydrinate: AEs
drowsiness, dry mouth, confusion in older adults
54
2nd line for motion-induced N?
scopolamine
55
MOA of scopolamine?
anticholinergic
56
Scopolamine: AEs
dry mouth, urinary retention, palpitations
57
Constipation: What is the goal of tx'ing constipation in palliative pts on opioids?
Bowel movement at least q3 days
58
T or F: Nonpharm approaches to preventing/tx'ing constipation in palliative pts are usually the best.
F (risk of obstruction if not enough fluids are consumed)
59
T or F: Tolerance does NOT develop to opioid-induced constipation.
T
60
What should be used as prophylaxis for opioid-induced constipation?
Stimulant and/or osmotic laxative +/- stool softener
61
How to tx opioid-induced constipation?
Suppository or enema
62
What is used if stimulant/osmotic laxatives and stool softeners have failed?
Methylnaltrexone
63
MOA of methylnaltrexone?
Peripheral (intestinal) acting selective µ-opioid antagonist
64
When should methylnaltrexone be d/c'ed?
if it's not effective after 4 doses
65
One of the most feared aspects of dying?
Dyspnea
66
First line for dyspnea?
Opioids
67
List why opioids are preferred in pts suffering from dyspnea?
- reduce resp effort - central sedative effect > lowers ventilatory response - lower sensitivity to hypercapnia and hypoxemia - reduce O2 consumption - reduce perception of dyspnea and anxiety
68
In pts suffering from dyspnea, what should be used if there're respiratory panic attacks?
BZD
69
When does dyspnea increase dramatically in terms of occurrence and severity?
in the last 48h of life
70
What can develop in pts who're undergoing cancer tx or chronic CS tx?
Oral and esophageal candidiasis
71
Tx for oral and esophageal candidiasis
Nystatin (local) or fluconazole (systemic)
72
What's an important counseling point for antifungal meds?
to continue for 7d after lesions have healed
73
What're some end-of-life symptoms/experiences experienced by the pt?
1. Nearing-death awareness 2. terminal restlessness 3. respiratory congestion
74
T or F: MAiD is part of palliative care.
F

PHAR 557 (36 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions