Palliative care Flashcards
(19 cards)
what pain treatment can you start a patient on
15mg MR morphine (MST) PO BD
+ 5mg IR oromorph PO PRN for breakthrough pain
IR = immediate release
MR = modified release
what to give all patients starting strong opiods
o Laxatives as opiods cause constipation
what is the dose of breakthrough dose you can give
1/6 of total morphine in 24h
what opioid is appropriate for GFR 30-60
oxycodone
what opioid is appropriate for GFR <30
alfentanyl
fentanyl
bupremorphine
how much do you increase opioid in if still in pain
increase by 1/3 of total daily dose
what is the first line antiemetic if nauseatied
CYCLizine
when is cyclizine contraindicated
if fluid retention / HF
what do you give as antiemetic if non nauseated
cyclizine PRN
or metoclopramide PRN if in fluid retentin
what meds do you give for aagitation or confusion
- haloperidol
2. chlorpromazine, levomepromazine , lorazepoam
what med can you give for secretions
muscarinic receptor antagonist
e.g. hyoscine hydrobromide. glycopyrronium
hyoscine dosage, route etc
hyoscine hydrobromide 1.2 mg SC over 24 hours
what med can you give for hiccups
chlorpromazine
what antiemetic can you give in nausea due to gastric stasis
metoclopramide (because it has prokinetic action)
morphine side effects
transient: nausea and drowsiness
persistent: constipation
weak opiods
codeine, tramadol, buprenorphine
strong opiods
morphine, diamorphine, fentanyl, oxycodone, alfentanil
management for bony metastasis pain
- Analgesia
- Bisphophonates
- Radiotherapy
codeine dosage
- 30 mg oral every 4 hours
