Palliative Care

Question 1

Medication for secretion control in EoL care?

Answer 1

Hyoscine butylbromide

Hyoscine hydrobromide or hyoscine butylbromide is generally used first-line to manage secretions in a palliative care setting

Question 2

Treatment options for metastatic bone pain

Answer 2

analgesia
radiotherapy
bisphosphonates

Question 3

Which analgesia is preferred in mild-moderate renal impairment in palliative care?

Answer 3

oxycodone

(eGFR 10-50 mL/min/1.73^2)

morphine is contraindicated in patients with renal impairment due to concerns about accumulation and toxicity.

Question 4

What are the opioids of choice for pain relief in palliative care
patients with severe renal impairment?

Answer 4

Buprenorphine or fentanyl

(eGFR<10)

-> as they are not renally excreted and therefore are less likely to cause toxicity than morphine

Question 5

What is pembrolizumab?

Answer 5

immunotherapy

checkpoint inhibitor

Question 6

Hyoscine hydrobromide / butylbromide MoA

Answer 6

muscarinic receptor antagonist

Question 7

which antiemetic is recommended for intracranial causes of N&V?

Answer 7

Cyclizine

is a good first line anti-emetic for intracranial causes of nausea and vomiting