A review of agents for palliative sedation/continuous deep sedation : pharmacology and practical applications

Article

BODNAR, John

Continuous deep sedation at the end of life is a specific form of palliative sedation requiring a care plan that essentially places and maintains the patient in an unresponsive state because their symptoms are refractory to any other interventions. Because this application is uncommon, many providers may lack practical experience in this specialized area and resources they can access are outdated, nonspecific, and/or not comprehensive. The purpose of this review is to provide an evidence- and experience-based reference that specifically addresses those medications and regimens and their practical applications for this very narrow, but vital, aspect of hospice care. Patient goals in a hospital and hospice environments are different, so the manner in which widely used sedatives are dosed and applied can differ greatly as well. Parameters applied in end-of-life care that are based on experience and a thorough understanding of the pharmacology of those medications will differ from those applied in an intensive care unit or other medical environments. By recognizing these different goals and applying well-founded regimens geared specifically for end-of-life sedation, we can address our patients' symptoms in a more timely and efficacious manner.

Voir la revue «Journal of Pain & Palliative Care Pharmacotherapy, 31»

Autres numéros de la revue «Journal of Pain & Palliative Care Pharmacotherapy»

Suggestions

Du même auteur

Terminal withdrawal of mechanical ventilation...

Article | BODNAR, John | Journal of intensive care medicine

The intensive care unit (ICU) and hospice inpatient unit (IPU) environments differ in many ways. Although both endeavor to provide the best care possible for their patients, the day-to-day goals of these environments are almost an...

Terminal withdrawal of mechanical ventilation...

Article indépendant | BODNAR, John | Journal of intensive care medicine

The intensive care unit (ICU) and hospice inpatient unit (IPU) environments differ in many ways. Although both endeavor to provide the best care possible for their patients, the day-to-day goals of these environments are almost an...

Terminal withdrawal of mechanical ventilation...

Article indépendant | BODNAR, John | Journal of intensive care medicine

The intensive care unit (ICU) and hospice inpatient unit (IPU) environments differ in many ways. Although both endeavor to provide the best care possible for their patients, the day-to-day goals of these environments are almost an...

De la même série

Use and discontinuation of milrinone for adva...

Article | WOLFE, Amanda | Journal of Pain & Palliative Care Pharmacotherapy | n°1 | vol.36

The use of intravenous inotropic medications in advanced heart failure (HF) has been shown to improve symptoms and decrease hospitalizations, prompting support for their use as a palliative measure for symptom management. Recommen...

Comparison of current post-graduate pain mana...

Article | MULLINS, Amanda M. | Journal of Pain & Palliative Care Pharmacotherapy | n°2 | vol.36

Post-graduate pharmacy residency training in pain management and palliative care is continuing to increase in availability. It is expected that there will be further expansion in the need for specialty trained pain and palliative ...

Dexmedetomidine continuous infusion for refra...

Article | BYRNE, Jennifer M. | Journal of Pain & Palliative Care Pharmacotherapy | n°3 | vol.36

Refractory cancer-related pain at end-of-life (EoL) is multifaceted and may require utilizing medications with different mechanism of actions beyond opioids. We report the successful use of dexmedetomidine in a 63-year old female ...

Substance abuse risk and medication monitorin...

Article | KUMAR, Pooja S. | Journal of Pain & Palliative Care Pharmacotherapy | n°2 | vol.35

Oncology and Palliative Medicine lack guidance on routine opioid risk screening and compliance monitoring. This study explored relationships among risk screening and aberrant medication related behaviors in patients with advanced ...

Pearls for opioid use in seriously ill patien...

Article | KRAL, Lee | Journal of Pain & Palliative Care Pharmacotherapy | n°1-2 | vol.33

Opioids are often the foundation of pain management in seriously ill patients. Unfortunately, even experienced providers carry with them information that they consider "fact", when this information is not based on scientific evide...

Chargement des enrichissements...