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Cheshire West Acid Test for DoLS — SCE Palliative Medicine MCQ

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HardLegal & Ethical FrameworkCheshire West Acid Test for DoLSSCE Palliative Medicine

A frail patient with complete malignant bowel obstruction has persistent nausea despite antisecretory treatment. Haloperidol is chosen for CSCI. Which specialist dose range is recommended?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Haloperidol 1–5 mg/24 hours, titrated to effect

Explanation lettering: E = shown as A · D = shown as C · A = shown as D · C = shown as E

E is correct. For persistent nausea in bowel obstruction, haloperidol may be added at 1–5 mg over 24 hours by CSCI and titrated to effect, using lower doses in renal failure and in elderly or frail patients. The indication is antiemesis, not reversal of the mechanical lesion.

Reference: Scottish Palliative Care Guidelines: bowel obstruction: https://www.rightdecisions.scot.nhs.uk/scottish-palliative-care-guidelines/symptom-control/bowel-obstruction/