Pharm

Question 1

Agitation & anxiety

Answer 1

Meds:Benzodiapines 
SE: Sedation, unsteadyness
Elderly = antipsychotics
Younger - antihistamine
Terminal- Benzo + antipsychotics

Question 2

Constipation

Answer 2

Stimulant laxatives if on opioids
- Lactulose, senna, casantherol, sorbitol, enemas
SE: cramps, bloating, N/V
- Determine if impacted

Question 3

Diarrhea

Answer 3

-Often assoc with chemo or infection.
-Motility inhibitors- immodium, kaopectate, opium
SE: Constipation, nausea, cramps
-Review diet, add fiber, pancreatic enzymes

Question 4

Diminished appetite

Answer 4

Address food, snack, supplement choices
- Meds to stimulate: megestrol,
SE: sexual dysfunction, rash
-marijuana, steroids, antihistamines, antidepressants, anabolic steroids

Question 5

Hiccoughs

Answer 5

• Meds: Antipsychotics
• SE: altered cardiac conduction
• Review eating hygiene- carbonation and high gas foods

Question 6

Depression:

Answer 6

Evaluate associated issues
Meds: SSRIs, tricyclics, SNRIs
SE: N, HA, insomnia

Question 7

Dyspnea/ air hunger:

Answer 7

Opioids & benzos to reduce need to breathe.
- SE: Resp depression, constipation
Bronchospasm- albuterol, ipratropium
CHF- furosemide

Question 8

Nausea/ vomiting

Answer 8

• Meds- Anitemetics: Serotonin antagonists, Dopamine antagonists
• SE: Seratonin- HA, constipation, Dopamine- hypotension
• Asses: GI status, frequency, volume, timing, hydration, pregnancy- Tx underlying if possible

Question 9

Pruritis

Answer 9

Med: Antihistamines
SE: Drowsiness
- rule out scabies

Question 10

Terminal delirium

Answer 10

Meds- Antipsychotics & sedation

AE: hypotension resp depression,

Question 11

Pain- Somatic

Answer 11

• Med: Opiods
• SE: Resp depression
  Goal to minimize breakthrough pain. Oral agents around the clock. No max dose. Titrate to side effects. Laxatives.

Question 12

Pain- Neuropathic

Answer 12

Med: Anticonvulsants
SE: Drowsiness,