Palliative care (passmed) Flashcards
(14 cards)
Which class of psychotropic drugs worsen confusion in the elderly and those with delirium?
Benzodiazepines can worsen confusion in elderly patients and those with delirium
What is the first-line antipsychotic medication recommended for the management of terminal delirium and why?
Oral Haloperidol - good safety profile and efficacy at treating hallucinations and agitation
Remember: HALoperidol for HALLucinations before people go to Heaven or Hell
What is the serious side effect if tramadol is prescribed in someone with severe renal impairment, despite it being contraindicated?
Seizures and serotonin syndrome
How would you treat metastatic bone pain? Name three approaches
Metastatic bone pain may respond to analgesia, bisphosphonates or radiotherapy
List various causes of nausea according to which treatment would be selected.
Raised ICP
GI obstruction
Chemotherapy
Radiotherapy
Migraine
Indications for cyclizine in pal care
Intracranial or intra-vestibular causes of nausea and vomiting.
Gastrointestinal obstruction
Movement disorders?
First line anti-emetic for intracranial/intravestibular N+V?
Cyclizine
Anti-emetic for GI pain in pal care
Domperidone
Why is domperidone helpful in GI pain in pal care?
It stimulates gastric muscle contraction by antagonising the inhibitory effect of dopamine
Anti-emetic for chemo/radiotherapy induced N+V
Metoclopramide
Anti-emetic for N+V caused by chemo
Ondansetron
MOA of ondansetron
It is a selective 5-hydroxytryptamine (5-HT3) antagonist.
Which drug could you add to cyclizine in the context of N+V caused by raised ICP?
Dexamethasone
Give some other indications for dexamethasone prescription
Spinal cord compression
Liver capsule pain
Anorexia
Nausea
