Articles: palliative-care.
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Support Care Cancer · Mar 2000
ReviewPsychopharmacology in supportive care of cancer: a review for the clinician: II. Neuroleptics.
Neuroleptics are frequently used in patients with advanced cancer. Most relevant and practical aspects of their use in supportive cancer care are reviewed, to assist the clinical oncologist and palliative care specialist when prescribing these drugs. This article reviews pharmacological properties, indications, such as delirium, nausea and vomiting, pain, anxiety and other symptoms, adverse effects, and drug interactions of neuroleptics and compares the profiles of different compounds. Special emphasis is put on the role of neuroleptics in the management of delirium.
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Support Care Cancer · Mar 2000
Case ReportsSuccessful palliation of hypoactive delirium due to multi-organ failure by oral methylphenidate.
Delirium is frequently observed in terminally ill cancer patients, but complete remission is often difficult to achieve. Therefore, symptom palliation is of great importance to improve patients' quality of life. ⋯ We report on a terminally ill cancer patient with hypoactive delirium caused by multi-organ failure, in whom methylphenidate was effective in improving the ability to maintain communication. This case highlights the efficacy of methylphenidate for hypoactive delirium in terminally ill cancer patients.
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Support Care Cancer · Mar 2000
Case ReportsMethadone as a rescue for failed high-dose opiate therapy for catastrophic pain.
Methadone is a unique opioid with several special properties besides being a mu agonist, which makes for difficulty in the calculation of equianalgesic doses. A series of three cases is presented to illustrate this point.
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In a 12-month period six people died from Creutzfeldt-Jakob disease (CJD) in a Melbourne hospice. CJD is a rare neurodegenerative disease, which commonly follows an explosive course unabated into the terminal phase. For the purposes of this article the care of six patients was audited using a retrospective chart review and a focus group was conducted with nurses involved in their care. ⋯ This review focuses on the particular care issues of six people with CJD and their families at the end of life. The personal issues experienced by the nurses who provided palliative care are also explored. The need for the future development of guidelines for families and health professionals who care for people with CJD is highlighted.