Primary Care/Palliative Care Flashcards
Bowel colic and excessive respiratory secretions (SC)
Hyoscine hydrobromide (sedative too)
Hyoscine butylbromide (less sedative)
Glycopyrronium bromide
Confusion and restlessness (SC)
Haloperidol (little sedative effect)
Levomepromazine (sedative effect)
Midazolam (is a sedative + antiepileptic. may be used in addition to an antipsychotic if v. restless) also used in myoclonus
Convulsions (SC)
If already on an antiepileptic should not be stopped
midazolam is drug of choice
Nausea and vomiting (SC)
haloperidol
levomepromazine (limited by sedative effect)
cyclizine likely to precipitate (esp with diamorphine)
metoclopramide hydrochloride can cause skin reactions
Octreotide (gi effect of water and electrolyte absorption + reduced intestinal secretions) reduces vomiting due to bowel obstruction
Pain control (SC)
Diamorphine Hydrochloride is the preferred opioid
Anorexia
Prednisolone
Dexamethasone
Bowel colic and excessive respiratory secretions
Hyoscine hydrobromide
Hyoscine butylbromide
Glycopyrronium bromide
Capillary bleeding
Oral tranexamic acid
Local gauze soaked in tranexamic acid or adrenaline
Vit K in liver disease
Constipation
Regular laxatives e.g. lactulose with a senna preparation
Methylnaltrexone bromide opioid induced constipation
Convulsions
Oral Prophylaxis w/ phenytoin or carbamazepine
Diazepam Rectally
Phenobarbital IV
Midazolam SC
Dry mouth
Good mouth care
Sucking ice, chewing gum, artificial saliva
?candidiasis? nystatin/miconazole
Medication r/v
Dysphagia
Dex
Dysopnoea
Breathlessness at rest: Oral morphine
Anxiety: Diazepam
Obstructive: Dexamethasone
Fungating tumours
Regular dressings + antibacterials
Metronidazole
Gastro-intestinal pain
Loperamide hydrochloride
Hyoscine hydrobromide sub-lingual
Hyoscine butylbromide
Glycopyrronium bromide
Hiccup
Gastric distention: antacid + antiflatulent
Failure: metoclopramide hydrochloride
Failure again: baclofen/nifedipine/chlorpromazine hydrochloride
Insomnia
Benzodiazepines: temazepam
Intractable cough
Moist inhalation or regular oral morphine
Muscle spasm
Diazepam
Baclofen
Nausea and vomiting
Identify cause
Prokinetics (first line) metoclopramide hydrochloride (antimuscarinics antagonise)
Metabolic cause Haloperidol
Mechanical BO/raised ICP/motion sickness Cyclizine
Bedtime Levomepromazine
Adjunct: Dexamethasone
Pruritus
Emollients
Colestyramine
Raised intracranial pressure
Raised ICP: Dexamethasone
Restlessness and confusion
Haloperidol
Levomepromazine (also licenced to treat pain)
