Prescription: Palliative Care: Diamorphine PRN

PLAB 2 CaseBank
1

Where you are
You are FY2 in hospice care home

Who the patient is
Mrs. Maria Smith, aged 80, is diagnosed with metastatic pancreatic cancer

Other information
Patient is terminal palliative care has been prescribed. She has been referred from hospital to hospice
for the continuation of palliative care. She cannot eat or drink.

Special Note
None

What you must do
Write down the prescription of her palliative caste medications

Hospital Handover Note
Patient name: Maria Smith
Date of Birth: 25/03/1942
NHS Number:123456
Hospital No: 1234
Allergy: Penicillin
Reaction: Breathlessness

Dear Doctor,
Mrs. Maria Smith, aged 80, has been admitted in the Hospice Care Home with pancreatic cancer. She is
terminally ill and cannot eat or drink.

Plan:

  • Diamorphine 3mg SC every 4 hours (maximum 20mg) for pain.
  • Cyclizine 50mg TDS SC (maximum 150mg) for nausea and vomiting.
  • Hyoscine bromide 400 micrograms SC 4 hourly (maximum 2.4mg) for secretion.
  • Paracetamol 1g PO every 4 to 6 hours (maximum 4 g/day) for pain.
  • Atorvastatin 10mg PO OD

Shortcut:

  1. Only give PRN: Diamorphine, Cyclizine, Hyoscine, Midazolam
  2. Stop oral drugs: Paracetamol & Atorvastatin
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