Palliative/Hospice Care Flashcards
Should pts receive oxygen for dyspnea?
no
What is Tx of choice for dyspnea?
opioids
MOA unclear
reduces sensation of breathlessness
IV = PO
What is the opioid dosing interval for dyspnea?
q4h
ex. hydrocodone 5mg PO q4
Benzos are first line dyspnea Tx
a. true
b. false
b. false
can be used as adjunct NOT first line
What two benzos can be used ad adjunct Tx for dyspnea?
alprazolam
lorazepam
What is more important for constipation , measurable symptoms or patient perception?
patient perception
<3 BMs a week
What is treatment of choice for constipation?
stimulants
+/- stool softeners
Anorexia and cachexia are reversible with improved nutrition.
a. true
b. false
b. false
usually due to disease process
Aggressive nutrition might increase patient discomfort
a. true
b. false
a. true
3 drugs/classes to treat anorexia and cachexia?
progestins
corticosteroids
cannabinoids
anorexia and cachexia:
Major AE of progestins (megestrol, medroxyprogesterone) for weight gain?
thrombotic events
anorexia and cachexia:
Which Tx improves mood and appetite?
cannabinoids
anorexia and cachexia:
Which Tx improves appetite quickly and has delayed wight gain?
progestins
corticosteroids and cannabinoids have no effect on weight gain
Two drugs of choice for terminal secretions?
glycopyrrolate
hyoscyamine
Two less favorable drugs for terminal secretions?
atropine
scopolamine
2 drugs/classes to Tx weakness and fatigue?
corticosteroids
methylphenidate
corticosteroids usually have decreasing effects if used more than 4-6 weeks
Why is decreased oral intake sometimes positive?
may stimulate the release of endorphins due to dehydration
Who administers the lethal agent in physician assisted/medical assisted death?
the patient self-administers
__ is lethal medication is administered by someone else
euthanasia
What was one of the first countries to legalize medical aid in dying?
Switzerland
most flexible laws
facilities available for non-residents
US states that allow MAID:
California Colorado Oregon Vermont Washington Washington DC Hawaii Maine New jersey Montana
Must be __ years old for MAID
18
Must be diagnosed with a terminal illness with life expectancy < __ months for MAID
6
What is waiting period for MAID in US?
15 day minimum
2 waiting periods in Washington, Oregon, Vermone, Hawaii, DC
