Palliative Care Order Set - Stratis Health

Palliative Care
Order Set Committee on Evidence-Based Practice/May 6, 2008
Fever Management (Annotation #13)
Acetaminophen*
Ibuprofen*
*See multi-symptom medications for specific orders
If neither of the above is effective, alternate ibuprofen dose with acetaminophen 650 mg by mouth every 4 hours
for fever (Consider if ibuprofen and/or acetaminophen is prescribed for pain management. Maximum dose
ibuprofen is 3,200 mg per day. Maximum dose acetaminophen is 4,000 mg per day.)
Hiccups Management (Annotation #14)
Chlorpromazine ____mg (25-50 mg) by mouth by IV every 6 hours as needed for hiccups
Baclofen 5 mg by mouth every 8 hours as needed for hiccups (Reduce dose for patients with renal
dysfunction)
Nausea/Vomiting Management (Annotation #15)
Dexamethasone*
Prochlorperazine
Droperidol
Promethazine
Haloperidol*
Lorazepam*
Metoclopramide*
*See multi-symptom medications for specific orders
Droperidol ____mg (0.625-1.25 mg) IV every 6 hours as needed for nausea/vomiting
Prochlorperazine ____mg (5-10 mg) by mouth 4 times daily 30 minutes before meals and at bedtime as needed
for nausea/vomiting
Prochlorperazine ____mg by rectal suppository every 12 hours as needed for nausea/vomiting
Promethazine ____mg (6.25-25 mg) by mouth IV every 6 hours as needed for nausea/vomiting
Oral Care Management (Annotation #16)
Topical viscous lidocaine 2% 5mL every 4 hours by mouth. Swish and spit as needed for mouth pain
Magic mouthwash/hematology mouthwash (viscous lidocaine 2% - 60 mL, diphenhydramine elixir 60 mL,
aluminum hydroxide/magnesium hydroxide 60 mL) 1-2 tsp by mouth. Swish and swallow or swish and spit
3-4 times/day as needed for mouth pain
Candida Treatment
Clotrimazole 10 mg troche, dissolve in mouth 5 times a day for candida. Discontinue after 14 days of
treatment
Nystatin (100,000 units/1 mL) 5 mL for candida. Swish and swallow 4 times a day for 7 days, then
evaluate
Fluconazole 200 mg by mouth initially for candida, then 100 mg by mouth daily for 7 days, then evaluate
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