Initial Palliative Care Drugs' Side Effect

Abstract

Introduction: The initial palliative care includes pharmacological palliative treatment of pain, depression, anxiety , delirium, nausea and dyspnea. Objective: To study the drugs administered to oncologic patients in initial palliative care and its possible side effects. Methods: This retrospective study included 40 oncologic patients with mean age of 69+14.12 under initial palliative care. Results: Opioids, benzodiazepines, neuroleptics, non-steroidal anti-inflammatory drugs (NSAID), corticosteroids had been prescribed in initial palliative care. Opioids such as fentanyl 0.007 mg/kg/day (3.3%), meperidine 0.64 mg/kg/day (3.3%), tramadol 7.4 mg/kg/day (3.3%), methadone 0.2 mg/kg/day (6.70%) and morphine 0.05 mg/kg/day (70.0%) were given for pain control. For anxiolytic and sedative effects, benzodiazepines such as bromazepam 0.092 mg/kg/day (3.3%), diazepam 0.31 mg/kg/day (3.3%), lorazepam 0.012 mg/kg/day (6.7%), alprazolam 0.006 mg/kg/day (6.7%), midazolam 0.014mg/kg/day (13.0%), clonazepam 0.67 mg/kg/day (20.0%), were administered. Levomepromazine 0,65 mg/kg/day (6,70%), quetiapine 0,25mg/kg/day (6,7%), haloperidol 0,06 mg/kg/day (26,7%), chlorpromazine 0,13 mg/kg/day were the neuroleptics prescribed for delirium/hallucination. In pain adjuvant therapy, NSAID such as dipyrone 3.7 mg/kg/day (90.00%), ketoprofen 2.7 mg/kg/day (6.70%) and tenoxicam 0.79mg/kg/day (3.3%) were administered. To treat nausea/vomiting dexamethasone 0.11 mg/kg/day was given to 53.40% patients. Constipation (66,60%), urinary retention (33,30%), nausea/vomiting (33,30% and hypotension (16,60%), motor agitation (33,30%) were described in this study as pharmacological side effects. Conclusions: Drug-related agranulocytosis and hypotension should be observed with the administration of dypirone. Respiratory depression with the association of opiods and benzodiazepines; extrapyramidal side effect (akathisia) due to administration of neuroleptics and dexamethasone immunosuppression should be considered in these patients' drug prescription.

Improving the Emotional Distress and the Experience of Hospitalization in Children and Adolescent Patients Through Animal Assisted Interventions: A Systematic Review

“…This condition could delay treatment, or lead to a longer time to recover, also reducing patient and family satisfaction. Traditionally, pharmacological therapies have been prescribed to manage anxiety and stress in this condition, but this is often associated with high costs and harmful side effects, including constipation and nausea ( Jiang et al, 2004 ; Ravindran and da Silva, 2013 ; Taniguchi et al, 2015 ). Therefore, the advent of non-pharmacologic approaches based on emotional regulation and humanization of care through complementary therapies has drawn the attention of the medical community ( Connor and Miller, 2000 ; Ravindran and da Silva, 2013 ; Taniguchi et al, 2015 ; Gilmer et al, 2016 ).…”

“…Traditionally, pharmacological therapies have been prescribed to manage anxiety and stress in this condition, but this is often associated with high costs and harmful side effects, including constipation and nausea ( Jiang et al, 2004 ; Ravindran and da Silva, 2013 ; Taniguchi et al, 2015 ). Therefore, the advent of non-pharmacologic approaches based on emotional regulation and humanization of care through complementary therapies has drawn the attention of the medical community ( Connor and Miller, 2000 ; Ravindran and da Silva, 2013 ; Taniguchi et al, 2015 ; Gilmer et al, 2016 ). Among complementary interventions, Animal-Assisted Interventions (AAIs) appear to represent a highly suitable approach that could be implemented in children’s education and care ( Cirulli et al, 2011 ; Davis et al, 2015 ; Correale et al, 2017 ).…”