Journal of palliative medicine
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In geriatrics, most risk factors associated with falls have been identified and management strategies developed accordingly. This is not the case in palliative care. The incidence rate of falls, the consequences related to falls, and other related factors were determined in elderly cancer patients hospitalized for palliative care in an exploratory study. ⋯ Characteristics of falls in palliative care appear different from those evidenced in geriatric wards. To prevent delirium while prescribing neuroleptic drugs with the greatest caution should help decrease the number of falls in this highly vulnerable group of patients.
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Methadone is generally believed to be devoid of neuroexcitatory properties, and its use is increasing. This paper reports two cases of myoclonus with high-dose parenteral methadone in patients with cancer under hospice care. ⋯ Possible mechanisms for methadone causing myoclonus include a redistribution of receptor saturation in the N-methyl-D-aspartate (NMDA) and delta receptors. Ketamine may be an option for patients with intractable pain who develop methadone-induced myoclonus.