A 76-year-old woman with advanced heart failure is thought to be entering the last days of life. She is drowsy, taking little orally and increasingly ...

Question

A 76-year-old woman with advanced heart failure is thought to be entering the last days of life. She is drowsy, taking little orally and increasingly bedbound. What is the most appropriate approach to prescribing for common end-of-life symptoms?

Accepted Answer

Set up anticipatory prescriptions (for example, subcutaneous Morphine, Midazolam, Levomepromazine and an antimuscarinic) for use as needed

Answer

Only prescribe medications when symptoms occur

Answer

Stop all medications including symptom control drugs

Answer

Prescribe high-dose opioids pre-emptively whether or not she is in pain

Answer

Delay any changes until the patient or family request them

uk-plab-1 MCQ (SBA): Anticipatory prescribing at end of life

A 76-year-old woman with advanced heart failure is thought to be entering the last days of life. She is drowsy, taking little orally and increasingly bedbound. What is the most appropriate approach to prescribing for common end-of-life symptoms?