Pallmedpro
@pallmedpro.bsky.social
Lucy, Jonathan and Rosanna are three Palliative Care consultants who make up Pallmedpro - an educational partnership who help palliative medicine doctors prepare for exams. Follow for questions, overlooked facts, and evidence-based CPD in palliative care.
Have you read Soliman et al.'s 2025 systematic review and meta-analysis in the management of neuropathic pain? How might it change your practice? www.thelancet.com/action/showP...
www.thelancet.com
October 1, 2025 at 10:16 AM
Have you read Soliman et al.'s 2025 systematic review and meta-analysis in the management of neuropathic pain? How might it change your practice? www.thelancet.com/action/showP...
Good morning from the gallery! Looking forward to going live at 9 after our intro VT 🎬
October 1, 2025 at 7:39 AM
Good morning from the gallery! Looking forward to going live at 9 after our intro VT 🎬
Our Resources Portal is now open to delegates on our 2025 course, who should now all have logins. We’ll be adding to it as the course gets underway, including enabling our practice question bank. Visit pallmed.pro/resources, or book your course place via pallmed.pro/book if you haven’t already!
September 24, 2025 at 12:21 PM
Our Resources Portal is now open to delegates on our 2025 course, who should now all have logins. We’ll be adding to it as the course gets underway, including enabling our practice question bank. Visit pallmed.pro/resources, or book your course place via pallmed.pro/book if you haven’t already!
Have you learned your controlled drug schedules? Knowing the relevant schedules and the legal restrictions placed upon common palliative care medicines can be helpful, along with how you may need to advise patients looking to take these medicines abroad. GOV.UK has more: www.gov.uk/guidance/con...
September 9, 2025 at 3:06 PM
Have you learned your controlled drug schedules? Knowing the relevant schedules and the legal restrictions placed upon common palliative care medicines can be helpful, along with how you may need to advise patients looking to take these medicines abroad. GOV.UK has more: www.gov.uk/guidance/con...
Opioids for chronic breathlessness ≠ “last resort”. Currow & Johnson (2020) remind us: low‑dose morphine can improve function & QoL when optimised, monitored, and individualised. Not about sedation — about living better, breathing easier.
September 3, 2025 at 9:51 AM
Opioids for chronic breathlessness ≠ “last resort”. Currow & Johnson (2020) remind us: low‑dose morphine can improve function & QoL when optimised, monitored, and individualised. Not about sedation — about living better, breathing easier.
Our revision flashcards are in the process of being updated for 2025-2026, with some great new content added. You'll be able to pre-order the 8th Edition from 15th September, for release on 1st October. Course delegates can claim a FREE update in October. pallmed.pro/flashcards
Palliative Medicine SCE Flashcards
pallmed.pro
August 31, 2025 at 9:03 AM
Our revision flashcards are in the process of being updated for 2025-2026, with some great new content added. You'll be able to pre-order the 8th Edition from 15th September, for release on 1st October. Course delegates can claim a FREE update in October. pallmed.pro/flashcards
🧠 Under the MCA 2005 (England & Wales), we decide for an adult lacking capacity by asking what’s in their ‘best interests’. In Scotland’s Adults with Incapacity Act, that phrase never appears. The focus shifts to benefit and least restrictive option, with statutory principles front and centre.
August 28, 2025 at 5:29 PM
🧠 Under the MCA 2005 (England & Wales), we decide for an adult lacking capacity by asking what’s in their ‘best interests’. In Scotland’s Adults with Incapacity Act, that phrase never appears. The focus shifts to benefit and least restrictive option, with statutory principles front and centre.
Reposted by Pallmedpro
💊💊ALFENTANIL💊💊
Alfentanil’s pKa ~6.5, much lower than fentanyl (~8.4) or morphine (~8.0)
At physiologic pH (7.4), ~90% of alfentanil exists in the unionised, lipid-soluble form → crosses the blood–brain barrier very rapidly
This explains why alfentanil has the fastest onset of action of any opioid
Alfentanil’s pKa ~6.5, much lower than fentanyl (~8.4) or morphine (~8.0)
At physiologic pH (7.4), ~90% of alfentanil exists in the unionised, lipid-soluble form → crosses the blood–brain barrier very rapidly
This explains why alfentanil has the fastest onset of action of any opioid
August 27, 2025 at 5:55 PM
💊💊ALFENTANIL💊💊
Alfentanil’s pKa ~6.5, much lower than fentanyl (~8.4) or morphine (~8.0)
At physiologic pH (7.4), ~90% of alfentanil exists in the unionised, lipid-soluble form → crosses the blood–brain barrier very rapidly
This explains why alfentanil has the fastest onset of action of any opioid
Alfentanil’s pKa ~6.5, much lower than fentanyl (~8.4) or morphine (~8.0)
At physiologic pH (7.4), ~90% of alfentanil exists in the unionised, lipid-soluble form → crosses the blood–brain barrier very rapidly
This explains why alfentanil has the fastest onset of action of any opioid
Did you know, that the half life of phenobarbitone is an average of 4 days?! The way we use it in palliative care needs to be proportionate, specialist-led, and congruent with known pharmacokinetics. @bmj.com Supportive and Palliative Care has more: spcare.bmj.com/content/earl... #palliativecare
Novel staggered loading of phenobarbitone for refractory seizures and agitation at the end of life
Background Seizures and agitation are distressing symptoms commonly encountered at the end of life and may require treatment with phenobarbitone when standard therapies fail. Current phenobarbitone do...
spcare.bmj.com
August 20, 2025 at 8:36 AM
Did you know, that the half life of phenobarbitone is an average of 4 days?! The way we use it in palliative care needs to be proportionate, specialist-led, and congruent with known pharmacokinetics. @bmj.com Supportive and Palliative Care has more: spcare.bmj.com/content/earl... #palliativecare
Although an older study, this placebo-controlled double-blind RCT found no net benefit using SC ketamine in general cancer pain. 6 years later, Fallon et al. Looked more specifically at neuropathic cancer pain. pubmed.ncbi.nlm.nih.gov/22965960/
Randomized, double-blind, placebo-controlled study to assess the efficacy and toxicity of subcutaneous ketamine in the management of cancer pain - PubMed
Ketamine does not have net clinical benefit when used as an adjunct to opioids and standard coanalgesics in cancer pain.
pubmed.ncbi.nlm.nih.gov
August 17, 2025 at 10:03 AM
Although an older study, this placebo-controlled double-blind RCT found no net benefit using SC ketamine in general cancer pain. 6 years later, Fallon et al. Looked more specifically at neuropathic cancer pain. pubmed.ncbi.nlm.nih.gov/22965960/
Grief, according to Kübler-Ross:
Heard grief has “5 stages” you must follow? Denial → anger → bargaining → depression → acceptance was never a rigid sequence. Kübler-Ross saw it in those facing terminal illness. You might skip, loop, or feel several at once. It’s a guide, not a timetable.
Heard grief has “5 stages” you must follow? Denial → anger → bargaining → depression → acceptance was never a rigid sequence. Kübler-Ross saw it in those facing terminal illness. You might skip, loop, or feel several at once. It’s a guide, not a timetable.
August 14, 2025 at 9:20 AM
Grief, according to Kübler-Ross:
Heard grief has “5 stages” you must follow? Denial → anger → bargaining → depression → acceptance was never a rigid sequence. Kübler-Ross saw it in those facing terminal illness. You might skip, loop, or feel several at once. It’s a guide, not a timetable.
Heard grief has “5 stages” you must follow? Denial → anger → bargaining → depression → acceptance was never a rigid sequence. Kübler-Ross saw it in those facing terminal illness. You might skip, loop, or feel several at once. It’s a guide, not a timetable.
Follow us for your continuing professional development in palliative medicine.
August 11, 2025 at 5:58 AM
Follow us for your continuing professional development in palliative medicine.
Naloxegol’s long tail prevents it from reaching the CNS where it would otherwise reverse the analgesic effects of opioids. It works peripherally in the gut.
August 10, 2025 at 3:10 PM
Naloxegol’s long tail prevents it from reaching the CNS where it would otherwise reverse the analgesic effects of opioids. It works peripherally in the gut.
Let’s talk Opioid-Induced Constipation (1/4)
On opioids and can’t go? It’s not you, it’s your gut. Opioids slow bowel movement, dry out stool, and cut gut secretions. That’s a recipe for constipation – even with a great diet.
On opioids and can’t go? It’s not you, it’s your gut. Opioids slow bowel movement, dry out stool, and cut gut secretions. That’s a recipe for constipation – even with a great diet.
August 10, 2025 at 10:41 AM
Let’s talk Opioid-Induced Constipation (1/4)
On opioids and can’t go? It’s not you, it’s your gut. Opioids slow bowel movement, dry out stool, and cut gut secretions. That’s a recipe for constipation – even with a great diet.
On opioids and can’t go? It’s not you, it’s your gut. Opioids slow bowel movement, dry out stool, and cut gut secretions. That’s a recipe for constipation – even with a great diet.
Which of the following statements about octreotide is most accurate?
1️⃣ Exerts action through somatostatin receptor blockade
2️⃣️ Increases insulin secretion
3️⃣ Commonly causes hyperthyroidism
4️⃣ Increases variceal bleeding risk
5️⃣ Is labelled with technetium in nuclear medicine imaging
📊 Show results
1️⃣ Exerts action through somatostatin receptor blockade
2️⃣️ Increases insulin secretion
3️⃣ Commonly causes hyperthyroidism
4️⃣ Increases variceal bleeding risk
5️⃣ Is labelled with technetium in nuclear medicine imaging
📊 Show results
August 6, 2025 at 7:54 AM
Which of the following statements about octreotide is most accurate?
1️⃣ Exerts action through somatostatin receptor blockade
2️⃣️ Increases insulin secretion
3️⃣ Commonly causes hyperthyroidism
4️⃣ Increases variceal bleeding risk
5️⃣ Is labelled with technetium in nuclear medicine imaging
📊 Show results
1️⃣ Exerts action through somatostatin receptor blockade
2️⃣️ Increases insulin secretion
3️⃣ Commonly causes hyperthyroidism
4️⃣ Increases variceal bleeding risk
5️⃣ Is labelled with technetium in nuclear medicine imaging
📊 Show results
Our Palliative Medicine course is open to everyone, and it’s been great to see delegates booking from across the world. If the time zones don’t fit, remember you get access to our resources, handouts, questions and more. Drop us a line or check out pallmed.pro/book for more!
Palliative Medicine SCE Revision Course
Booking page for Pallmedpro's Palliative Medicine SCE Revision Course
pallmed.pro
August 1, 2025 at 7:55 AM
Our Palliative Medicine course is open to everyone, and it’s been great to see delegates booking from across the world. If the time zones don’t fit, remember you get access to our resources, handouts, questions and more. Drop us a line or check out pallmed.pro/book for more!
Delighted that @pharmacopalliation.bsky.social will be presenting again at this year’s course (pictured left) We’re looking forward to it!
July 19, 2025 at 11:38 AM
Delighted that @pharmacopalliation.bsky.social will be presenting again at this year’s course (pictured left) We’re looking forward to it!
BOOKING OPENS 9am GMT+1 for our 12th annual Palliative Medicine Exam Revision Course. Whether you’re a UK or international doctor sitting the Specialty Certificate Examination, or an established professional looking for CPD, check out our topic list below, or visit Pallmed.pro/book for more!
July 16, 2025 at 5:19 AM
BOOKING OPENS 9am GMT+1 for our 12th annual Palliative Medicine Exam Revision Course. Whether you’re a UK or international doctor sitting the Specialty Certificate Examination, or an established professional looking for CPD, check out our topic list below, or visit Pallmed.pro/book for more!
So many familiar faces! Jonathan’s at #PCC2025 today, so if you’ve seen our flashcards, been on one of our courses, authored in (/already read) Case Histories in Palliative Medicine, or just want to say ‘hi’, please do! oxford.ly/4hG4C9B
oxford.ly
March 21, 2025 at 7:07 AM
So many familiar faces! Jonathan’s at #PCC2025 today, so if you’ve seen our flashcards, been on one of our courses, authored in (/already read) Case Histories in Palliative Medicine, or just want to say ‘hi’, please do! oxford.ly/4hG4C9B
Good luck to all Palliative Medicine SCE candidates. You've done all you can do now. Step away from the PCF.
March 4, 2025 at 11:35 AM
Good luck to all Palliative Medicine SCE candidates. You've done all you can do now. Step away from the PCF.
Delegates on our December 2024 course are now entitled to 30% discount on this title. A personal discount code can be activated via your resources portal for a limited time.
February 16, 2025 at 5:48 PM
Delegates on our December 2024 course are now entitled to 30% discount on this title. A personal discount code can be activated via your resources portal for a limited time.
It’s finally here! @oxfordunipress.bsky.social Oxford Case Histories in Palliative Medicine “guides medical professionals and trainees through 52 cases curated to illustrate the varied and often complex landscape of palliative medicine.”
oxford.ly/4hG4C9B
oxford.ly/4hG4C9B
February 10, 2025 at 9:10 PM
It’s finally here! @oxfordunipress.bsky.social Oxford Case Histories in Palliative Medicine “guides medical professionals and trainees through 52 cases curated to illustrate the varied and often complex landscape of palliative medicine.”
oxford.ly/4hG4C9B
oxford.ly/4hG4C9B
Reposted by Pallmedpro
TRAMADONT: Ten reasons to avoid Tramadol.
a stop sign that is red and white
ALT: a stop sign that is red and white
media.tenor.com
December 6, 2024 at 8:10 PM
TRAMADONT: Ten reasons to avoid Tramadol.
Sitting the #Palliative Medicine SCE? Here’s a question for you on #Macmillan grants…
January 16, 2025 at 12:29 PM
Sitting the #Palliative Medicine SCE? Here’s a question for you on #Macmillan grants…
Who prescribes parenteral NSAIDs in cancer pain management? COX-2 selective agents show fewer GI side effects and have a lesser impact on platelet aggregation than their non-selective counterparts. Parecoxib, a pro-drug of valdecoxib, is a COX-2 selective NSAID licenced for parenteral use.
January 11, 2025 at 6:27 PM
Who prescribes parenteral NSAIDs in cancer pain management? COX-2 selective agents show fewer GI side effects and have a lesser impact on platelet aggregation than their non-selective counterparts. Parecoxib, a pro-drug of valdecoxib, is a COX-2 selective NSAID licenced for parenteral use.