Category Archives: Palliative care

Refractory opioid-induced constipation

As anyone with even a smattering of palliative care knowledge should be aware, opiates typically cause constipation and a laxative should typically be co-prescribed. This week’s BMJ has a useful tip on what to do about opioid-induced constipation that is … Continue reading

Posted in Credits 2017, Medication, Palliative care | Leave a comment

Nausea and vomiting in palliative care

I get involved with a lot of palliative care, so this BMJ review article on management of this very common problem was well worth the read. Good news, first off; as problems go, this is one that’s very amenable to … Continue reading

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Palliative care

(From BMJ learning module) Palliative Care Adult Network Guidelines Plus are a useful resource. Opiates in renal impairment Some good ones: Oxycodone, which is 90% excreted by the liver and only needs dose reduction in CKD5 Fentanyl – fine down … Continue reading

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Symptom control in end-stage renal failure

ESRF, apart from being fairly imminently fatal (approx 8 – 11 days on average without dialysis), can give rise to fairly unpleasant symptoms – nausea/vomiting, itching, weight loss, & intractable fluid overload. A difficulty in treatment is that many drugs … Continue reading

Posted in Nephrology, Palliative care | Leave a comment

Palliative care

Batting order of anti-emetics: Metoclopramide Haloperidol Levomepromazine Oxycodone may cause fewer central SEs than morphine. Different patients can have different levels of response to morphine & oxycodone. For breakthrough pain, use buccal, sublingual, or intranasal medication – oral takes too … Continue reading

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