IntroductionThe sedation could consist in a therapeutic strategy in advanced cancer conditions.ObjectiveTo study the drugs administered to patients under Palliative Care Sedation (PCS) audits effects on vital signs.MethodsOur retrospective study included 101 oncological patients with mean age of 66.5 ± 13.4 years old and mean weight of 48.5 ± 3.36 kg, under PCS. The data were analysed applying the test of Wilcoxon.ResultsThe drugs administered to these patients under PCS were morphine 55 mg/kg/day associated to midazolam 52.5 mg/kg/day (Morph/Midazo) or the association of morphine 55 mg/kg/day, midazolam 52.5 mg/kg/day and neuroleptics such as chlorpromazine 54.5 mg/kg/day or haloperidol 13.25 mg/kg/day (Morph/Midazo/Neurol). The values of vital signs of these patients when the sedation was initiated were: systolic blood pressure 116.55 ± 16.98 mmHg, diastolic bloodpressure73.17 ± 10.55 mmHg, heart rate 83.41 ± 16.25bpm, respiratory rate 19.39 ± 3.97 rpm and body temperature 35.91 ± 0.57 °C. No significant differences between these groups were observed. Vital signs measures were collected 48 hours before the patient's death. Significant reduction in systolic blood pressure 77.5 mmHg, diastolic blood pressure 43.3 mmHg were observed in the group (Morph/Benzo/Neurol). The Wilcoxon test for independent samples to a significance level of 5% we obtain a P-value of 0.01. The sedation period was 2.56 ± 0.23 days.ConclusionNeuroleptic, a central nervous system (CNS) depressant drug, when associated to other two depressants (morphine/midazolam), conducted to the patient's vital signs reduction.Considering the short period of time between the beginning of sedation and the patients’ death; and that palliative sedation should not include the hastening of patients’ death, we suggest a better drug association criteria.Disclosure of interestThe authors have not supplied their declaration of competing interest.
IntroductionAntiparkinsonian drugs increase dopaminergic system activity in order to compensate dopamine neurons degeneration in corpus striatum.ObjectivesTo study antiparkinsonian drugs hallucinatory side effectMethodsOur study included 28 geriatric patients enrolled in a private long-term care institution with mean age 84.93 ± 5.71 years old, weight mean 66.36 ± 2.83 kg with Parkinson’s disease.ResultsDrugs administered to patients with Parkinson’s disease were studied.The association of L-DOPA and DOPA descarboxylase inhibitor (benserazide) were administered to 53%(15) in doses between 2.0-19.0 mg/kg/day.L-DOPA associated to catechol-O-methyltransferase inhibitor (entacapone)3 mg/kg/day were given to 7.14% (2) patients.Bromocriptine 0.04 mg/kg/day were given to 3.57% (1) patient.39.29% (11) did not received any antiparkinsonian drug.Mental confusion and hallucination side effect were observed in 53.33%(8) patients treated with L-DOPA associated to DOPA descarboxylase inhibitor (benserazide).ConclusionThe increase of dopamine levels due to the administration L-DOPA, in corpus striatum improved Parkinson’s disease symptoms although undesirable effect related to dopamine activity at mesocortical pathway such as confusion and hallucination were observed.
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