Palliative Care

Question 1

what does this encompass?

Answer 1

symptom control
adaptation, environment, equipment
psychological support
communication

Question 2

slow release morphine examples

Answer 2

MST

zomorph

Question 3

immediate release morphine examples

Answer 3

oramorph

sevredol

Question 4

when are syringe drivers used?

Answer 4

when the oral route is compromised

Question 5

how do syringe drivers work?

Answer 5

continuous SC infusion

Question 6

how strong is SC morphine

Answer 6

twice as strong as PO so 1/2 dose

Question 7

presentation of opioid toxicity

Answer 7

hallucinations
myoclonus
drowsiness
respiratory depression (late)

Question 8

management of opioid toxicity

Answer 8

naloxone

Question 9

what happens to morphine if renal function is impaired?

Answer 9

it accumulates

Question 10

how strong is oxycodone?

Answer 10

twice as strong as morphine

Question 11

opioids to use in severe renal impairment

Answer 11

fentanyl

alfentanil

Question 12

recognition of the dying

Answer 12

worsening weakness
progressive fatigue
loss of interest in food/ fluid
breathing change

Question 13

pharmacological principles in end of life care

Answer 13

only continue essential

prioritse opioids

Question 14

pain/SOB

Answer 14

morphine

Question 15

distress

Answer 15

midazolam

Question 16

nausea

Answer 16

levomepromazine

Question 17

secretions

Answer 17

buscopan

Question 18

confirmation of death

Answer 18

observe for 5 minutes for:

• absence of carotid pulse (1 min)
• no heart sounds (1 min)
• no resp (1 min)
• no response to pain (trapezius squeeze)
• fixed, dilated pupils (1 min)