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Gastrointestinal Symptoms in Palliative Care

Introduction. Nausea and vomiting reported by 40-70%Constipation reported by 50% of hospice inpatientsDry mouth reported by over 75%. Overview. Nausea and vomitingPathways and receptorsEvaluation CausesReceptor-specific anti-emeticsMalignant intestinal obstructionCausesClinical features

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Gastrointestinal Symptoms in Palliative Care

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    1. Gastrointestinal Symptoms in Palliative Care Dr Peter Nightingale Macmillan GP

    2. Introduction Nausea and vomiting reported by 40-70% Constipation reported by 50% of hospice inpatients Dry mouth reported by over 75%

    3. Overview Nausea and vomiting Pathways and receptors Evaluation Causes Receptor-specific anti-emetics Malignant intestinal obstruction Causes Clinical features management

    4. Overview Constipation Causes Associated symptoms Management/laxative guidance Mouth care Dry mouth Oral candidiasis

    5. Nausea and Vomiting

    6. Which of the following is true? A Cyclizine and metoclopramide is a logical combination of drugs B Steroids are unhelpful in malignant bowel dysfunction C Cyclizine and Haloperidol is a powerful combination of antiemetics D Metoclopramide can help colicy pain in malignant bowel dysfunction

    7. Definitions Nausea A feeling of the need to vomit May be accompanied by autonomic symptoms Retching Rhythmic, laboured, spasmodic movements of the diaphragm and abdominal muscles Vomiting Forceful expulsion of gastric contents through the mouth e.g. pallor, cold sweat, salivation, tachycardia Generally in the presence of nausea and often culminates in vomiting Incidence: 40-70% of patients with advanced cancere.g. pallor, cold sweat, salivation, tachycardia Generally in the presence of nausea and often culminates in vomiting Incidence: 40-70% of patients with advanced cancer

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