PALLIATIVE CARE

Question 1

Treatment of N+V?
- Central
- Peripheral

Answer 1

CENTRAL
- Vestibular: antihistamines
- Aprepitant: NK1
- Ondans: 5HT3 –> radio/chemo
- Benzos: GABA –> anxiety

PERIPHERAL
- Halo/Metaclop/Domp: not in Parkinson’s
- Use halo for chemical/drug induced
- Secretions: Ocretide, Ranitidine

Question 2

Steroid indications?

Answer 2

Low dose 2-4 mg/day
Appetite
Weakness
Mood

Mid dose 4-6 mg/day
Antiemetic
Co analgesic

High dose 16mg/day
Metastases compression/ obstruction
Raised ICP

Question 3

Pain calculations
- SC –> PO
- Morphine to oxycodone/ hydro morph

Answer 3

SC –> PO: 3 to 1

Morphine –> oxycodone: 1 to 1.5

Question 4

Treatment options for seizures?

Answer 4

Midaz: SC IV IM
Levetericetam: SC
Clonaz: SC SL IV

Question 5

SE’s of opioids?

Answer 5

Hyperalgesia
Myoclonus
Serotonin syndrome
Seizures –> benzo
Itch

Question 6

Disease trajectory of cancer