“Palliative Care”. Dr David Plume MBBS DRCOG MRCGP Macmillan GPF, GP Advisor and Primary Care Network Lead. “Palliative Care”. “talk about medicine” or “talk about air” Enormous subject! Feedback regarding questionnaires and PPoC Choice of Topic Areas:
Dr David Plume MBBS DRCOG MRCGP
Macmillan GPF, GP Advisor and Primary Care Network Lead.
Nausea is worse than vomiting.
Occurs in 60% of people with advanced cancer.
-Examine fundi for papilloedema
-Distension / ascites
-Presence or absence of bowel sounds
- Specific drug levels if indicated
? Stop gastric irritant drugs
R. Twycross 1997
-If little benefit, reassess the cause and change to appropriate first-line anti-emetic.
-?converting to oral route after > 3 days.
-Continue indefinitely unless the cause is self-limiting.
Symptomatic drug treatment
Correct the correctable
Breathless on exertion
Breathless at rest
Repeated 4hrly as needed
A syringe driver should be commenced if a 2nd stat dose is needed within 24hrs
Remember to prescribe stats
Review & adjust dose daily if needed
If secretions are present, two options.
A) Hyoscine Butylbromide (Buscopan)
CSCI-0.6-1.2mg /24 hrs
Remember Stats at appropriate doses
Review & adjust dose daily