Control of symptoms

Question 1

palliative care adult network guidelines

Answer 1

http://book.pallcare.info/

Question 2

steroids

Answer 2

can cause a temporary increase in appetite (short term)

Question 3

prokinestic antiemetic (for gastric stasis or peristaltic failure)

Answer 3

metoclopramide (D2) (injectable and can go in a syringe driver)

domperidone

Question 4

target chemical causes which acts on the chemoreceptor trigger zone

Answer 4

haloperidol (D2)

Question 5

acting on the vomiting centre (final common pathway)
intracranial pressure
vestibular causes
bowel obstruction

Answer 5

cyclizine (H1, ach)

Question 6

ubiquitous dexamethasone

Answer 6

has various indications

• tumor compression
• reduce inflammation and swelling
• bowel obstruction
• used in cerebral oedema to reduce raised ICP

pain
- neuropathic, liver capsule, radiotherapy flare

appetite stimulant

2mg-16mg
look for glucose intolerance (BM peak late afternoon)
proximal myopathy
agitatin/psychosis
gastritis (PPIs)

Question 7

buscapan

Answer 7

anti-secretory and anti-spasmotic

used in bowel obstruction
reduces salivary secretions
glycopyrronium, hyoscine

Question 8

octreotide

Answer 8

anti seretory
reduces volume of vomits in bowel obsturction
high output fistulae

Question 9

baclofen

Answer 9

muscle spasm

hiccups

Question 10

midazolam

Answer 10

anxiety
breathlessness
seizures
pain crises