Journal of pain and symptom management
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J Pain Symptom Manage · Jul 2020
ReviewChronic Obstructive Pulmonary Disease: A palliative medicine review of the disease, its therapies and drug interactions.
Despite significant advances in treatment, chronic obstructive pulmonary disease (COPD) remains a chronic and progressive disease that frequently leads to premature mortality. COPD is associated with a constellation of significant symptoms, including dyspnea, cough, wheezing, pain, fatigue, anxiety, depression, and insomnia, and is associated with increased morbidity. Palliative care is appropriate to support these patients. ⋯ This review describes COPD and current targeted therapies and their effects on symptoms, exercise tolerance, HRQL, and survival. It is important to note that medications commonly used for symptom management in palliative care can interact with COPD medications resulting in increased risk of adverse effects, enhanced toxicity, or changes in clearance of medications. To address this, we review pharmacologic interactions with and precautions related to use of COPD therapies in conjunction with commonly used palliative care medications.
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J Pain Symptom Manage · Jul 2020
Multicenter StudyAssociation between heart rate and reversibility of the symptom, refractoriness to palliative treatment, and survival in dyspneic cancer patients.
Dyspnea is one of the most distressing symptoms for terminally ill cancer patients and a predictor of poor prognosis. Identification of simple clinical signs, such as heart rate, indicating clinical course of each patient is of value. ⋯ Heart rate may help clinicians to make the prediction of the patient's clinical course more accurate.
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J Pain Symptom Manage · Jul 2020
Spiritual Distress Manifested in a Teenager Following a Stem Cell Transplant.
A mother and nurse 20 years after her son's tragic death, after a high-risk stem cell transplant, learns that his major behavioral changes while in strict isolation came under the term of spiritual distress. Through her personal experience, the writer describes how her son's thoughts and feelings were expressed in behaviors, atypical for his usual demeanor. This article highlights the importance and value of healthcare providers listening to a parent's perceptions of their child's state of mind. Atypical behavior could be a manifestation of spiritual distress and requires further assessment from the health care team.