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Nausea and vomiting in palliative care

Nausea and vomiting in palliative care. Katharine house hospice 2008. General principles. There is a single cause in 66% cases. Optimise non-pharmacological measures. Reverse the reversible. Diagnose a cause before initiating drug treatment.

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Nausea and vomiting in palliative care

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  1. Nausea and vomiting in palliative care Katharine house hospice 2008

  2. General principles • There is a single cause in 66% cases. • Optimise non-pharmacological measures. • Reverse the reversible. • Diagnose a cause before initiating drug treatment. • Give the most suitable drug by the most suitable route. • When multiple drugs are required, they should have different modes of action. • Review at least every 24 hours.

  3. Causes of nausea & vomiting

  4. Non-pharmacological measures • Fresh air. • Good oropharyngeal hygiene. • Suitable distractions. • Nurse in the upright position. • Avoidance of emetogenic smells and foods. • Avoidance of situations in which N&V is a conditioned response.

  5. Food presentation • Small portions, carefully prepared and presented. • The following foods may be appreciated: • Cold, bland or sour foods • Clear liquid diets • Tonic water

  6. Gastric stasis GI obstruction Chemo & RT

  7. Gastric stasis GI obstruction D2 + 5HT3 + 5HT4

  8. Gastric stasis GI obstruction Levomepromazine Ondansetron

  9. Gastric stasis GI obstruction Levomepromazine D2 + 5HT3 + 5HT4 Ondansetron

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