Abstract | BACKGROUND:
Shortness of breath and cough are common, disturbing symptoms in patients receiving palliative care. They arise in 10% to 70% of patients with advanced cancer and in 60% to nearly 100% of patients with non-malignant underlying diseases, depending on the type of disease. METHODS: This review is based on a selective literature search in the Medline, Embase, and PsycInfo databases and on current recommendations from Germany and other countries, as well as on the authors' personal experience. RESULTS: Some general measures to address these problems are reassurance, development of an emergency plan, physical activity, and relaxation exercises. Supportive non-pharmacological measures may include the use of a rollator (level of evidence [LoE] 1-), a cool draft of air as from a handheld fan (LoE 1-), physiotherapy, and respiratory therapy. There is good evidence (LoE 1+) to support the administration of opioids as the medications of choice; benzodiazepines are often used, but a meta-analysis did not reveal any statistically significant benefit (LoE 1+). Expectorants can help patients who cough with marked sputum formation. Antitussants suppress the cough reflex both peripherally and centrally (LoE 1+ to 3). Opioids, including morphine (LoE 1-) and dextromethorphan (LoE 1-), are effective antitussants with low toxicity. CONCLUSION:
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Authors | Claudia Bausewein, Steffen T Simon |
Journal | Deutsches Arzteblatt international
(Dtsch Arztebl Int)
Vol. 110
Issue 33-34
Pg. 563-71; quiz 572
(Aug 2013)
ISSN: 1866-0452 [Electronic] Germany |
PMID | 24069091
(Publication Type: Journal Article, Meta-Analysis, Review)
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Topics |
- Combined Modality Therapy
- Comorbidity
- Cough
(epidemiology, nursing)
- Dyspnea
(epidemiology, nursing)
- Female
- Humans
- Incidence
- Male
- Mind-Body Therapies
(statistics & numerical data)
- Palliative Care
(methods, statistics & numerical data)
- Physical Therapy Modalities
(statistics & numerical data)
- Risk Factors
- Treatment Outcome
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