Palliative care monthly meeting

Palliative care monthly meeting Speaker: Dr Eric Liang 14 June 2011

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Seminar A1 “ Let me die…..” ,[object Object],[object Object],[object Object],[object Object]

Examples of unhelpful responses ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Important issue: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Example 1 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Example 2 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Example 3 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Palliative chemotherapy: benefit or burden? ,[object Object],[object Object],[object Object]

What are patient’s attitude towards chemo ,[object Object],[object Object],[object Object],[object Object],[object Object]

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When to prescribe palliative chemo? ,[object Object],[object Object],[object Object],[object Object]

Example 1 ,[object Object],[object Object],[object Object],[object Object]

Example 2 ,[object Object],[object Object],[object Object],[object Object],[object Object]

Example 3 ,[object Object],[object Object],[object Object]

Depression & anxiety in palliative care A “Normal” response to dying? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Management of anxiety ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

medications ,[object Object],[object Object],[object Object],[object Object],[object Object]

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Demoralisation Impact on patients & caregivers ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Differentiation form depression ,[object Object],[object Object],[object Object],[object Object],[object Object]

Clinical association of demoralization syndrome ,[object Object],[object Object],[object Object],[object Object],[object Object]

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Treatment for difficult cancer pain ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Stop & go method ,[object Object],12:1 morphine >300mg/day 8:1 morphine 90-300mg/day 4:1 morphine <90mg/day stop Day 1 Methadone dose morphine

3 day Edmonton rotation schedule 2.5mg methadone 20mg morphine 20mg morphine 20mg morphine Breakthrough opioid 15mg /day 15mg Target dose 10mg 2/3 target dose 5mg 1/3 target dose methadone Cease morphine 66mg decrease 1/3 135mg decrease 1/3 morphine Day 4 Day 3 Day 2 Day 1 opioid

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Management of cancer pain ,[object Object],[object Object],[object Object],[object Object],[object Object]

Benefits of interventional techniques ,[object Object],[object Object],[object Object],[object Object]

Peripheral nerve block ,[object Object],[object Object],[object Object],[object Object]

Epidural or intrathecal? ,[object Object],[object Object],[object Object],[object Object]

opioids ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

morphine ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Local anaesthetic ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Neurolytic technique ,[object Object],[object Object],[object Object],[object Object],[object Object]

Intrathecal neurolysis ,[object Object],[object Object],[object Object],[object Object]

Coeliac plexus block ,[object Object],[object Object],[object Object],[object Object],[object Object]

Complications ,[object Object],[object Object],[object Object],[object Object]

Other neurolytic blocks ,[object Object],[object Object],[object Object]

Summary ,[object Object],[object Object],[object Object],[object Object],[object Object]

Palliative care monthly meeting

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Palliative care monthly meeting