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- Top PDF Treating nausea and vomiting in palliative care: a review
- Nausea and vomiting in palliative care
- Nausea and Vomiting: a Palliative Care Imperative
When the cause of symptoms is known, the antiemetic should be chosen depending on its receptor affinity. Antiemetic drugs work by binding to specific receptor sites in the chemoreceptor trigger zone CTZ or vomiting centre VC in the brainstem. At each site, there are several receptors; the more strongly the drug binds to the receptor, the more potent its antiemetic activity.
Top PDF Treating nausea and vomiting in palliative care: a review
The management of nausea and vomiting for individuals receiving palliative care can be complex. Note: prokinetic agents may trigger oesophageal spasm. Non-pharmacological measures are important and should be considered alongside the prescribing of appropriate anti-emetics. Measures include:. Almost all causes of nausea and vomiting can be placed in the following categories, and managed using a specific drug or class of drugs.
Nausea and vomiting in palliative care
Severe nausea, vomiting, or retching can be among the most disabling of symptoms. Wood and colleagues reviewed various instruments available for the assessment of cancer-related nausea, vomiting, and retching 2. Twenty-four tools evaluating nausea were identified that met their inclusion criteria. Thirteen tools measured vomiting as a separate experience. Only 3 tools included a separate assessment of retching.
Nausea and vomiting in palliative care are commonly experienced symptoms, and the aetiology is often multifactorial. The most common causes are impaired gastric emptying, chemical causes eg medication and visceral causes eg constipation. Close attention should be paid to the clinical features which may suggest the likely cause. Antiemetic therapy should be guided by the likely aetiology, although in practice, the clinical picture is often complex, and so regular reassessment is essential for adequate symptom control. Nausea and vomiting are common, distressing symptoms in patients receiving palliative care. Nausea and vomiting may be due to the primary disease, treatment sequelae medication, anti-cancer therapies and co-existing disease. Common pitfalls include poor assessment, using inappropriate antiemetics and using multiple antiemetics with the same mechanism of action.
Download PDF. Nausea and vomiting are common and often require attention in palliative-care settings. Treatment is most straightforward if a single cause for a patient's nausea and vomiting can be identified. Often, however, the cause is multifactorial and not readily apparent. As a result, it is frequently necessary to treat the patient's symptoms while simultaneously seeking a potentially reversible cause.
Nausea and Vomiting: a Palliative Care Imperative
The goal was to integrate findings in a comprehensive article that incorporates palliative care concepts into antiemetic treatment. Most articles are written by oncologists who also specialize in palliative care, and those addressing adverse effects of drugs used as antiemetics are found in other literature. Articles addressing more novel therapies, like cannabinoids and medical marijuana, are uncommon in the oncology literature. Nausea is more common and persistent, and even mild nausea is bothersome and may cause anxiety or depression.
Professional Reference articles are designed for health professionals to use. You may find the Nabilone capsules article more useful, or one of our other health articles. NICE has issued rapid update guidelines in relation to many of these. This guidance is changing frequently. Nausea and vomiting are distressing symptoms in patients receiving palliative care for advanced cancer.
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Click on image for details. Correspondence Address : Dr. The patients often present to palliative care with intractable nausea and vomiting.
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