Term
| Common Manifestations: Confusion |
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Definition
| anticholinergics, benzodiazepines |
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Term
| Common Manifestations: Depression |
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Definition
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Term
| Common Manifestations: Lack of Appetite |
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Definition
| SSRIs and other antidepressants |
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Term
| Common Manifestations: Weakness |
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Definition
| antihistamines/BBs/statins/benzos |
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Term
| Common Manifestations: ataxia |
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Definition
| benzos, anti-hypertensives |
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Term
| Common Manifestations: constipation |
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Definition
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Term
| Common Manifestations: urinary retention |
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Definition
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Term
| < 6 months to live; separate medication benefit; covers comfort care, not curative |
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Definition
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Term
| may have terminal illness, could be condition in which they live for years; pay for meds w/ standard pharmacy benefit; can receive broader scope of txt |
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Definition
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Term
| can be used if patient is not opioid-naive |
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Definition
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Term
| Fentanyl patch be ineffective |
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Definition
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Term
| concentrated solutions (small volume, easier to mix with food) MUST be careful with dosing!!! |
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Definition
| morphine 20 mg/mL; oxycodone 5 mg/mL; methadone 10 mg/mL |
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Term
| may be useful on as-needed basis or short-term; could be difficult for long term management |
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Definition
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Term
| Allow most flexible dosing; SC may be preferable at home with lower infection risk, SC has volume limitations as the dose increases |
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Definition
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Term
| Useful if other methods not effective; more complicated procedure; allow drug delivery to most localized area |
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Definition
| Epidural or Intrathecal Route |
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Term
| Patient can take more medication |
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Definition
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Term
| Physical symptoms if don't get med |
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Definition
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Term
| taking drug becomes more important than the original benefit from it |
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Definition
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Term
| increases the risk of aspiration, diarrhea, and other complications; does not lead to better quality of life or longer life |
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Definition
| Tube feeding at end of life |
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Term
| sometimes used for severe nausea because it is a very strong dopamine blocker |
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Definition
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Term
| May make constipation worse |
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Definition
| Promethazine, Prochlorperazine |
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Term
| Has NMDA receptor antagonist properties; makes it useful for allodynia in some cases |
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Definition
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Term
| pain that can be caused from simple touch (sheets, pressure from clothing, etc) |
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Definition
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Term
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Definition
| can accumulate; dose cautiously; not a first line agent but may be useful in some cases |
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Term
| some MDS will use for advanced allodynia cases; used in anesthesia most common, also bloks NMDA receptors |
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Definition
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Term
| Given for inflammation that can be the cause of pain |
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Definition
| Glucocorticoids; Bisphosphonates; NSAIDs |
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Term
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Definition
| Dexamethasone 12-20 mg/day; Prednisone 10-50mg/day |
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Term
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Definition
| High dose; Zoledronic acid common |
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Term
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Definition
| less effective than glucocorticoids; consider possible adverse reactions |
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Term
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Definition
| "Air hunger"; subjective symptoms of not being able to breathe; may occur with progressive cancer and other conditions |
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Term
| Target for terminal dyspnea |
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Definition
| respiratory center in brain |
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Term
| Respiratory center in brain |
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Definition
| in terminal dyspnea it is like a thermostat that keeps heat pumping out when temp is already too hot |
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Term
| may calm respiratory center down |
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Definition
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Term
|
Definition
| oral may be easiest to use; nebulized may be effective but may cause bronchospasm |
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Term
| for nebulized route, most common; can be given every 4 hours initially; based on patient need |
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Definition
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Term
| possible nebulized alternatives |
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Definition
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Term
| calm respiratory center, help with anxiousness |
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Definition
| Benzodiazepines (lorazepam often used) |
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Term
| can be used for excessive oral secretions |
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Definition
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Term
| excessive secretions: often preferred because a low dose can be used |
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Definition
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Term
| may need for drowsiness/fatigue from opioids or other treatments; sometimes cannot cut down the dose for treatmnts; even caffeine can be helpful in more mild cases |
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Definition
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Term
| much more lipophilic as compared to morphine and has a more rapid onset of action |
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Definition
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Term
| I-isomer responsible for drug's analgesic effects; drug accumulation secondary to a long half life is a potential risk as well as potential for arrhythmias |
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Definition
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Term
| potent mu-opiate receptor agonist |
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Definition
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Term
| high-potency antipsychotic structurally related to droperidol; boxed warning regarding an increased risk of death in elderly patients with dementia receiving these drugs for behavioral problems |
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Definition
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Term
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Definition
| blocks postsynaptic dopamine receptors |
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Term
| enhances GI motility and is an effective anti-nauseant; also blocks D2 dopaminergic receptors in the chemoreceptor trigger zone |
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Definition
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Term
| prototype antimuscarinic; competitive inhibitor at autonomic postganglionic cholinergic receptors |
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Definition
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