What else is new (other symptoms) DR ANDREW DAVIES

Similar documents
Syringe driver in Palliative Care

Prevention and Management of cancer disease and of chemo-and radiotherapyinduced nausea and vomiting

Supporting Last Days of Life Symptom Control Medication Guidance: Algorithm. Agitation & Anxiety

Oral problems DR ANDREW DAVIES

We would like to thank you for completing this audit questionnaire which looks at how you manage nausea and vomiting in palliative care patients.

[Type text] Anticipatory Medication STAT dose and Syringe Driver Guidance [Type text]

PAIN MANAGEMENT Person established taking oral morphine or opioid naive.

Constipation and bowel obstruction

Renal Palliative Care Last Days of Life

SYRINGE DRIVER MEDICATIONS

Supportive Care. End of Life Phase

PAIN MANAGEMENT Patient established on oral morphine or opioid naive.

Clatterbridge Centre for Oncology

Implementing the recommendation on medication management and symptom control

Anticipatory Medications for End of Life Patients. Doses must be proportional to the current analgesic medication YES NO YES NO

Nausea and Vomiting in Palliative Care

Renal Prescribing at End of Life Guidance for Anticipatory prescribing for patients in renal failure (egfr<30) at the end of life

PAIN AND SYMPTOM MANAGEMENT GUIDANCE IN THE LAST DAYS OF LIFE

End of life prescribing guidance

Care in the Last Days of Life

Algorithms for Symptom Management. In End of Life Care

A RANDOMISED, OPEN LABEL STUDY OF GUIDELINE DRIVEN TARGETED ANTIEMETIC THERAPY VERSUS SINGLE AGENT ANTIEMETIC THERAPY

This survey aims to look at individual practice and can be completed by any healthcare professional.

End Stage Liver Disease Regional Audit Casenote Survey

SYMPTOM MANAGEMENT GUIDANCE FOR PATIENTS RECEIVING PALLIATIVE CARE AT ROYAL DERBY HOSPITAL

ANTICIPATORY PRESCRIBING FOR PATIENTS AT END OF LIFE WITH RENAL IMPAIRMENT

Care of the Dying. For dosing in severe renal impairment see separate guidance for care of the dying in severe renal failure.

Diamorphine 4 hour. alfentanil (500microgram/mL) Calculated by dividing 24 hour oral morphine dose by 30

Care of the Dying Management in Severe Renal Failure

Using syringe pumps in palliative care

Syringe Drivers. Back to top

SYMPTOM CONTROL IN THE LAST DAYS OF LIFE. Bradford, Airedale, Wharfedale & Craven

MMG035 Symptom Management Guidelines for a Person thought to be in the Last Few Days and Hours of Life

Care of the Dying Management in Severe Renal Failure

ALLERGIES/ SENSITIVITIES This section must be completed before prescribing/administering any drug

Pancreatic cancer Palliative Care

Guidelines for the Use of Anti-Emetics with Chemotherapy

The last days of life in hospital and at home

BACKGROUND Measuring renal function :

PRESCRIBING GUIDELINES FOR SYMPTOM MANAGEMENT IN THE DYING PATIENT

Nausea & Vomiting. Dr Eve Lyn TAN Liverpool Hospital NSW, AUSTRALIA

For patients and their carers this means smoother symptom control, better support in a crisis, and avoidance of admission if that is their choice.

Managing Adverse Events in the Cancer Patient. Learning Objectives. Chemotherapy-Induced Nausea/Vomiting

MASCC/ESMO ANTIEMETIC GUIDELINE 2016

GUIDELINES FOR PRESCRIBING AT THE END OF LIFE FOR PATIENTS WITH RENAL IMPAIRMENT (estimated glomerular filtration rate<30)

Health Learning Partnership End of Life Care 29 th June 2016

West Midlands Palliative Care Physicians. Palliative care. Guidelines for the use of drugs in symptom control

What s New 2003? What new treatments? What have you discontinued? More information please!

Anticipatory prescribing and end of life considerations. Dr Stephanie Lippett

EAST LANCASHIRE GUIDELINES FOR THE MANAGEMENT OF SYMPTOMS IN THE LAST DAYS OF LIFE

OPIOID-INDUCED CONSTIPATION DR ANDREW DAVIES

Symptom Control in the Community Setting. Dr Andrew Tysoe-Calnon

PENNINE LANCASHIRE GUIDELINES FOR THE MANAGEMENT OF SYMPTOMS IN THE LAST DAYS OF LIFE

Palliative Care Impact Survey

PHARMACY SERVICE ARRANGEMENTS FOR THE SUPPLY OF PALLIATIVE CARE SYRINGES AND MEDICINES FOR COMMUNITY PATIENTS

Palonosetron vs Ondansetron for prevention of postoperative nausea and vomiting in...

Management of common chemotherapy related side effects. Dr Lee-Ann Jones

Pediatric Trials 23/04/2018. Disclosures. Nausea and Vomiting Control in Adults and Children: Mind the Gap! Learning Objectives

PRESCRIBING PRACTICE IN DELIRIUM. John Warburton Critical Care Pharmacist

PRIMARY CARE PALLIATIVE CARE FORMULARY

MASCC Guidelines for Antiemetic control: An update

ANTIEMETIC GUIDELINES: MASCC/ESMO

Review Article Treatment of Breakthrough and Refractory Chemotherapy-Induced Nausea and Vomiting

GUIDELINES ON THE MANAGEMENT OF PAIN DUE TO CANCER IN ADULTS

Palliative Care. Anticipatory Prescribing Guidelines & June Gippsland Region Palliative Care Consortium Clinical Practice Group

Doncaster & Bassetlaw Cancer Locality. Palliative Care Core Formulary

PRIMARY CARE PALLIATIVE CARE FORMULARY

Guideline Update on Antiemetics

Measure Abbreviation: PONV 01 (MIPS 430)

Gastrointestinal obstruction in palliative care: a review

Policy/Standard Operating Procedure/ Clinical Guideline. ELHT/CP22 Version 5.1. ELHT/CP22 Version 4.1

Why Patients Experience Nausea and Vomiting and What to Do About It

CONTINUOUS POSITIVE AIRWAY PRESSURE (CPAP)

Gastrointestinal obstruction Dr Iain Lawrie

Patient & Family Guide

Measure Abbreviation: PONV 01 (MIPS 430)

Symptom Management Guidelines for End of Life Care

Palliative care in long-term conditions Scottish Palliative Care Pharmacists Association

Using Evidence Based Medicine to Ethically Provide End of Life Symptom Control

Trust Guideline for Prevention and Control of Chemotherapy and Radiotherapy Induced Nausea and Vomiting in Adults

Isle of Wight Syringe Driver Compatibility Guidelines

Palliative Prescribing - Pain

TRANSPARENCY COMMITTEE OPINION. 31 January Date of marketing authorisation: 22 March 2005 (centralised marketing authorisation)

ESMO HIGHLIGHTS SUPPORTIVE AND PALLIATIVE CARE

MND Just in Case kit Information for GPs

Symptom Management. Thomas McKain, MD, ABFM, ABHPM Medical Director

Controlling nausea and vomiting: anti-emetic therapy advice

Clinical Policy: Nabilone (Cesamet) Reference Number: ERX.NPA.35 Effective Date:

Part 2: Pain and Symptom Management Nausea and Vomiting

End of Life Care. Dr Anne Garry Consultant in Palliative Medicine

SUBCUTANEOUS AS REQUIRED & SYRINGE PUMP PRESCRIPTION & ADMINISTRATION RECORD (SPAR) Name: Address: Postcode: Date of Birth: NHS Number:

Bulletin Independent prescribing information for NHS Wales

Regional Renal Training

Palliative care for heart failure patients. Susan Addie

DECONTAMINATION AGENTS and ANTIEMETICS *** This material won t be covered in lecture, but you are responsible for it***

Lothian Palliative Care Guidelines POCKET EDITION 2004

Chemotherapy Induced Nausea and Vomiting (CINV) Anti-emetic Guidelines

Systemic management of pancreatic cancer: Supportive care

Nausea and Vomiting Team. Outcome: Nausea and Vomiting. Scope of the Problem. Definition: Nausea

Transcription:

What else is new (other symptoms) DR ANDREW DAVIES

Outline Nausea & vomiting Petroleum jelly (and oxygen)

Nausea & vomiting

MASCC / ESMO recommendations

MASCC / ESMO recommendations General: The anti-emetic drug of choice in advanced cancer is metoclopramide (titrated to effect) MASCC level of consensus high MASCC level of confidence moderate

MASCC / ESMO recommendations General: Alternative options include haloperidol, levomepromazine, or olanzapine MASCC level of consensus high MASCC level of confidence low

MASCC / ESMO recommendations General: The use of cyclizine or 5-HT3 receptor antagonists is poorly defined to date and may be used where dopamine antagonists are contraindicated or ineffective MASCC level of consensus low MASCC level of confidence low

MASCC / ESMO recommendations Bowel obstruction: The drug recommended in a bowel obstruction is octreotide, dosed around the clock, and given alongside an antiemetic (with the committee recommending haloperidol) MASCC level of consensus high MASCC level of confidence high

MASCC / ESMO recommendations Bowel obstruction: If octreotide plus antiemetic is ineffective, the use of anticholinergic antisecretory agents (e.g., scopolamine butylbromide, glycopyrronium bromide) and/or corticosteroids is recommended as either adjunct or alternative interventions MASCC level of consensus high (moderate for corticosteroids) MASCC level of confidence moderate (low for corticosteroids)

MASCC / ESMO recommendations Bowel obstruction: The use of cyclizine or 5-HT3 receptor antagonists is poorly defined in this setting. Metoclopramide should be used with caution in partial bowel obstruction and should not be used in complete bowel obstruction MASCC level of consensus low MASCC level of confidence low

MASCC / ESMO recommendations Opioid-induced: No recommendation can be made for specific antiemetics, although various antiemetics may help. Opioid rotation and route switching ma be effective approaches. There is no data to support prophylactic antiemetics in this situation MASCC level of consensus high MASCC level of confidence low

Petroleum jelly (and oxygen)

Petroleum jelly

Petroleum jelly To prevent cracking of the lips, smear petroleum jelly (for example Vaseline ) on the lips. However, if a person is on oxygen apply a water-soluble lubricant (for example K-Y Jelly ). NICE: CKS Palliative care oral Vaseline or similar for lips (caution is necessary if a person is receiving oxygen, as Vaseline is flammable NEoLCP: End of life care learning resource pack

Petroleum jelly No case reports in MEDLINE!

Petroleum jelly Ignition temperature minimum temperature at which substance will ignite spontaneously Petroleum jelly: ~ 540 o F / 282 o C (similar to plastics used in oxygen equipment)

Petroleum jelly Flash point minimum temperature at which substance will ignite in presence of ignition source Petroleum jelly: ~ 400 o F / 204 o C (similar to plastics used in oxygen equipment)

Petroleum jelly Acknowledgments: Dr Matthew Dore Prof Max Watson Dr Clare White

Petroleum jelly YouTube clip burning petroleum jelly https://www.youtube.com/watch?v=8hauktnhlcg

Petroleum jelly YouTube clip burning oxygen tubing https://www.youtube.com/watch?v=asumr-n2e6k

2024 © healthdocbox.com Privacy Policy | Terms of Service | Feedback