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7262 MS Block 2 > Palliative/Hospice Care > Flashcards

Palliative/Hospice Care Flashcards

1
Q

Should pts receive oxygen for dyspnea?

A

no

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2
Q

What is Tx of choice for dyspnea?

A

opioids

MOA unclear

reduces sensation of breathlessness
IV = PO

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3
Q

What is the opioid dosing interval for dyspnea?

A

q4h

ex. hydrocodone 5mg PO q4

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4
Q

Benzos are first line dyspnea Tx

a. true
b. false

A

b. false

can be used as adjunct NOT first line

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5
Q

What two benzos can be used ad adjunct Tx for dyspnea?

A

alprazolam

lorazepam

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6
Q

What is more important for constipation , measurable symptoms or patient perception?

A

patient perception

<3 BMs a week

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7
Q

What is treatment of choice for constipation?

A

stimulants

+/- stool softeners

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8
Q

Anorexia and cachexia are reversible with improved nutrition.

a. true
b. false

A

b. false

usually due to disease process

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9
Q

Aggressive nutrition might increase patient discomfort

a. true
b. false

A

a. true

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10
Q

3 drugs/classes to treat anorexia and cachexia?

A

progestins
corticosteroids
cannabinoids

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11
Q

anorexia and cachexia:

Major AE of progestins (megestrol, medroxyprogesterone) for weight gain?

A

thrombotic events

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12
Q

anorexia and cachexia:

Which Tx improves mood and appetite?

A

cannabinoids

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13
Q

anorexia and cachexia:

Which Tx improves appetite quickly and has delayed wight gain?

A

progestins

corticosteroids and cannabinoids have no effect on weight gain

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14
Q

Two drugs of choice for terminal secretions?

A

glycopyrrolate

hyoscyamine

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15
Q

Two less favorable drugs for terminal secretions?

A

atropine

scopolamine

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16
Q

2 drugs/classes to Tx weakness and fatigue?

A

corticosteroids
methylphenidate

corticosteroids usually have decreasing effects if used more than 4-6 weeks

17
Q

Why is decreased oral intake sometimes positive?

A

may stimulate the release of endorphins due to dehydration

18
Q

Who administers the lethal agent in physician assisted/medical assisted death?

A

the patient self-administers

19
Q

__ is lethal medication is administered by someone else

A

euthanasia

20
Q

What was one of the first countries to legalize medical aid in dying?

A

Switzerland

most flexible laws
facilities available for non-residents

21
Q

US states that allow MAID:

A 
California
Colorado
Oregon
Vermont
Washington
Washington DC
Hawaii
Maine
New jersey
Montana
22
Q

Must be __ years old for MAID

A

18

23
Q

Must be diagnosed with a terminal illness with life expectancy < __ months for MAID

A

6

24
Q

What is waiting period for MAID in US?

A

15 day minimum

2 waiting periods in Washington, Oregon, Vermone, Hawaii, DC

25
Q

Which organization does not endorse a particular MAID position?

ASHP Or APhA?

A

APhA

relies on pharmacist’s professional judgement

26
Q

Which organization affirms pharmacist’s right to participate or decline in MAID?

ASHP or APhA?

A

ASHP

27
Q

What MAID medication is generally avoided?

A

antidepressants

28
Q

All medications for MAID must be given IV.

a. true
b. false

A

b. false

must be given ORALLY or per feeding tube by patient themselves

29
Q

What is considered gold standard for MAID?

A

short acting barbiturates

30
Q

What barbiturate and dose is the sole choice for short acting MAID in US?

A

secobarbital 9 grams

31
Q

Should chloral hydrate be used for MAID?

A

no

throat burning/pain

32
Q

What 3 drugs are in DMP MAID regimen?

A

diazepam
morphine
propranolol

33
Q

What 4 drugs are in DDMP MAID regimen?

A

diazepam
digoxin
morphine
propranolol

DDMP2 is same but 2x doses

34
Q

___ is an anti-emetic adjunct MAID agent that must be started 24 hours prior

A

metoclopramide

20mg PO q8h

take again 1 hour prior

35
Q

MAID meds should be taken on empty stomach.

a. true
b. false

A

a. true

prolonged if taken with food

7262 MS Block 2 (10 decks)

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