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AKT > Palliative/ Geris > Flashcards

Palliative/ Geris Flashcards

1
Q

Palliative medication: Agitation + confusion

A

Subcutaneous
1st - Haloperidol
2nd - chlorpromazine, levopromazine, midazolam

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1
Q

10mg PO Morphine equivalent PO opiates
codiene/ tramadol
oxycodone

A

Codeine/ Tramadol = 100mg (0.1 times)

Oxycodone = 6.6 (1.5 times)

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2
Q

Palliative nausea + vomiting Mx

A

Gastric motility - eg opiate related
- Metoclopramide, domperidone, haloperidol

Visceral (eg constipation)/ raised Intracranial pressure/ Vestibular
- Cyclizine

Cortical - eg pain, anxiety
- lorazepam, cyclizine

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3
Q

Conversion of PO Morphine to SC morphine

A

Divide by 2

Eg
PO Morphine 90mg = SC Morphine 45mg

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4
Q

Waterlow grading of pressure ulcers

A

Grade 1 - Non blanching erythema of intact skin

Grade 2 - Partial thickness skin loss involving dermis/ epidermis. (superficial abrasion/ blister)

Grade 3 - Full thickness skin loss to subcutaneous tissue not underlying fascia

Grade 4 - Extensive destruction, tissue necrosis - damage to muscle/ bone/ surrounding structures

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5
Q

Metastatic bone pain Mx

A

Analgesia
Bisphosphonates (eg zolendronic acid)
Radiotherapy

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6
Q

Breakthrough pain morphine calculation

A

x/6 = breakthrough dose

x = total dose over 24 hours

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7
Q

Donepezil SE

A

contraindication in bradycardia
SE = insomnia

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8
Q

Hiccups in palliative care Mx

A

Chlorpromazine
Haloperidol

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9
Q

Lewy body dementia Fx

A

visual hallucinations
dementia
Parkinsonism - eg resting tremors
Cognitive symptoms predate physical symptoms - this is the opposite for Parkinsons

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10
Q

Conversion of PO mOrphine to SC Diamorphine

A

Divide by 3

Eg. PO Morphine 90mg = SC Diamorphine 30mg

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11
Q

Lewy body dementia Mx

A

1st - Donepezil/ rivastigmine (Ach inhib)
2nd - Memantine

Do not prescribe neuroleptics as can develop parkinsonism

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12
Q

What medication is contraindicated in Parkinsons disease

A

Antipsychotics eg haloperidol

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13
Q

Delerium Mx

A

Address underlying cause, increase nursing care and modify environment

1st - Haloperidol 0.5mg PO

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14
Q

Palliative Mx - Respiratory secretions and Bowel colic

A

Hyoscine butylbromide
glycopyrronium bromide

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15
Q

PO Morphine to SC Diamorphine

A

Divide by 3

eg 120mg PO Morphine = 40mg SC Diamorph

16
Q

Hiccups in Palliative care Mx

A

chlorpromazine
haloperidol

17
Q

Alzheimer’s Mx

A

1st - donepezil, galantamine and rivastigmine (cholinesterase inhibitors)
2nd - Memantine

Donepezil - contra indicated in bradycardia. Can lead to insomnia

18
Q

Seizures in Palliative care Mx

A

Midazolam SC continuously

19
Q

What palliative medication must be mixed with water rather than saline

A

Cyclizine
All others mix with saline

20
Q
A

AKT (21 decks)

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