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Palliative IP > palliative pharm > Flashcards

palliative pharm Flashcards

1
Q

trade name dexamethasone

A

Decadron

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2
Q

dosage range dexamethasone

A

2-8 mg daily to BID

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3
Q

should you give PO dexamethasone with food?

A

yes, always!

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4
Q

indications for dexamethasone?

A

decrease inflammation, tx spinal cord compression, co-analgesic, decrease nausea, increase energy, increase appetite

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5
Q

major side effects of dexamethasone

A

sleep disturbance
increase energy & appetite
fluid retention
increase blood glucose

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6
Q

peak serum levels dexamethasone

A

1-2 hours

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7
Q

what should also be ordered with dexamethasone

A

PPI e.g. lansaprazole

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8
Q

2 trade names for hydropmorphone

A

dilaudid, hydromorph contin

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9
Q

dosage range hydropmorphone

A

0.25 mg to no max - limited by side effects experienced

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10
Q

renal impairment & hydropmorphone

A

has been used safely in pts with renal failure but use with caution as 3-glucuronide metabolite is neuroexcitatory and can accumulate

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11
Q

other than pain, what is an indication of hydropmorphone

A

dyspnea

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12
Q

what levels of pain is hydropmorphone indicated for?

A

moderate to severe

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13
Q

major side effects hydropmorphone

A

constipation, nausea & vomiting, delerium, dry mouth, hallucinations, myoclonus, unsteadiness, sweating, pruritus, drowsiness

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14
Q

onset of action unsteadiness PO & SC hydropmorphone

A

PO - 15 to 30 min

SC - 15 min

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15
Q

duration of action immediate & controlled release hydropmorphone

A

IR PO & SC - 4-5 hrs

CR - 12 hrs

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16
Q

is it appropriate to open the CR capsule and sprinkle it onto soft, cold food?

A

yes, but should should not be chewed, crushed, or dissolved d/t to potential for rapid release & absorption of fatal dose

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17
Q

what type of drug is Lorazepam

A

benzodiazepine

18
Q

dosage range Lorazepam

A
  1. 5 to 2 mg q2 to 12 h PRN

* will also see scheduled doses

19
Q

other than anxiety, what is Lorazepam indicated for?

A

antiemetic adjunct, initial tx of seizure, insomnia, agitation (acute and terminal)

20
Q

major side effects of Lorazepam

A 
sedation
Respiratory depression
Hypotension
Confusion
Dizziness
Akathisia 
Headache
Disorientation
Amnesia
21
Q

what is a more common route for lorazepam?

A

sublingual

22
Q

onset of action for SL vs. PO lorazepam

A

SL 5 min

PO 10-15 min

23
Q

duration of action lorazepam

A

duration of action of 6 to 72 hours

24
Q

what is the generic name of Haldol?

A

haloperidol

25
Q

what type of drug is haldol?

A

antipsychotic, D2-receptor antagonist (ā€œDā€ for dopamine)

26
Q

what are the indications for haldol?

A

Tx and prevention of N and V associated with opioids, hypercalcemia, renal failure, inoperable bowel obstruction
tx of agitation (delirium)

27
Q

major side effects haldol

A

Extrapyramidal side effects
Sedation
Hypotension

28
Q

Onset of action haldol

A

10 to 15 min SC or >1 hr PO

29
Q

duration of action haldol

A

up to 24 hrs

30
Q

what other medication can haldol be used with to tx agitation/restlessness?

A

midazolam

31
Q

at what doses are extrapyramidal side effects more likely?

A

> 5 mg/day

32
Q

what is the generic name for nozinan?

A

Methotrimeprazine

33
Q

what type of med is nozinan?

A

antipsychotic

34
Q

dosage range nozinan

A

5 to 25 mg q4, 6, or 8 h PRN

*may see scheduled

35
Q

what is the max dosage per day of nozinan?

A

300 mg

36
Q

indications of nozinan

A

Antiemetic, tx of terminal agitation and delirium, tx of palliative sedation, tx of nausea due to bowel obstruction, analgesic properties

37
Q

major side effects nozinan

A

Sedation, Postural hypotension, Tachycardia, Palpitations, Blurred vision, Dry mouth, Heartburn, Constipation, Hesitancy & retention of urine, Palpitations, Reduced sweating, Flushing

38
Q

Onset of action nozinan

A

30 min

39
Q

peak plasma concentration nozinan

A

PO is 1-3 h

SC is 30-90 min

40
Q

duration of action nozinan

A

12-24 hrs

41
Q

how is nozinan useful in relation to uncontrolled pain?

A

useful co-analgesic in very distressed pt with severe pain unresponsive to other measures

42
Q

what is nozinan indicated for in low doses?

A

antiemetic

Palliative IP (1 decks)

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