Palliative care Flashcards Preview

Medicine > Palliative care > Flashcards

Flashcards in Palliative care Deck (3)
Loading flashcards...
1

What are the essential PRN meds for the dying patient

Morphine 2.5mg
Midazolam 2.5mg
Glycoprrolate 0.2mg
Haloperidol 1.5mg

2

How do you convert oral morphine to IV/SC, titrate and and prescribe the maintenance dose?

PO dose divided by 2 = IV/SC dose

When making the syringe driver put the total amount (background + PRNs used) to run over 24hrs into to it and then devide this total amount by 6 to get the PRN dose.

The PRN dose it always 1/6 of the new total dose.

3

Which symptoms are important to manage in the dying patient and how do you manage them?

BREATHLESSNESS -
Do not over crowd.
Open window or get electric fan if can
Avoid lying flat
Can give benzos if related to anxiety or opioids if not related to exercise.

RESTLESSNESS/AGITATION-
Exclude reversible causes (full bladder, pain, fear)
Can give benzos or an antipsychotic

RETAINED SECRETIONS -
Explain to the relatives what the noise if and that it doesn't bother the patient.
Resposition by turning head to one side
Can give glycopyronium or hyosine

PAIN -
Use the pain ladder

NAUSEA and VOMITING -
Haloperidol can be used for drug induced, metabolic or malignant causes
Gastric irritation should be treated with lansoprazole
Treat any reversible causes