| Pain Management - Part 1 | Pain Management - Part 2 | Nausea/Vomiting Management | Seizure Management | Delirium/Agitation Management |
|---|---|---|---|---|
|
What is the bio-availability of SC:IV opioids or PR:PO of morphine or methadone
1:1 bio-availability
|
What is not absorbed rectally or topically.
Gabapentin
|
What is a combination that is felt to have low bio-availability rectally.
ABHR (ativan, benadryl, haldol, reglan) suppository
|
What is amount of volume a rectum can accommodate without defecation response.
10-30 mLs
|
What are treatments for agitation/delirium felt to be from underlying neurotoxicity.
Intravenous fluids, opioid rotation
|
|
What is the mLs of opioid that can be infused subcutaneously per hour and still be 100% bio-available.
3mLs
|
What are opioids with only 15-30% bio-availability.
Sublingual morphine, oxycodone, and dilaudid
|
What are rectal anti-emetics.
Compazine, Reglan, Zofran, and Thorazine
|
What is used in IV form to abort seizures or sublingually for seizure prophylaxis, but causes sedation.
Ativan
|
What is a gel that minimally systemically absorbs (only benadryl erratically).
ABH (ativan, benadryl, haldol) topical gel
|
|
What is the gauge of the needle used for subcutaneous infusions of opioids at home.
25/27G butterfly needle
|
What is able to act as a local anesthetic in wounds due to over expression of mu-opioid receptors.
Morphine intrasite gel
|
What is a transdermal anti-emetic.
Scopolamine
|
What is the standard AED used rectally (or IV) to prevent seizures without much sedation.
Valproic acid
|
What are agents used to treat refractory delirium/agitation as part of palliative sedation protocol at DH.
Pentobarbital and Midazolam
|
|
What is the only opioid that needs dose reduction when given rectally compared to orally.
oxycodone PR
|
What are all topical non-opioids used for local pain control with proven efficacy
Diclofenac, Amitriptyline, Lidocaine, and Capsaicin
|
What are sublingual anti-emetics.
Olanzapine, Risperidone, Atropine, or Levsin
|
What are rectal (or IV) agents to prevent seizures, but causes sedation.
Phenobarbital or Pentobarbital
|
What is an agent given rectally or intravenously to manage delirium refractory to haldol.
Thorazine
|
|
What are PR opioids.
Few hour delay in onset of action
|
What are the highest bio-availabilities for sublingual opioids (> 50%, > 50%, and 30-40%).
Fentanyl, Buprenorphine, and Methadone
|
What are subcutaneous anti-emetics.
Decadron, Scopolamine, and Haldol
|
What are agents used to abort status epilepticus (midazolam intranasal/buccal/SC, valium rectal).
Midazolam or Valium
|
What agents most commonly used by hospices to manage delirium at the end-of-life.
Ativan and Haldol
|
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