Nausea and vomiting in palliative care

Collis, Emily; Mather, Harriet

doi:10.1136/bmj.h6249

Cited by 24 publications

(34 citation statements)

References 38 publications

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“…Furthermore, N&V can result in significant physical complications including dehydration, electrolyte derangement and malnutrition. 8…”

Section: Clinical Featuresmentioning

confidence: 99%

“…Parenteral administration is recommended in cases of vomiting, poor GI absorption or significant gastric stasis. 8 For maximum effect, antiemetics should be prescribed on a regular basis, titrated according to response, and reviewed frequently for effectiveness and adverse effects. 2 Of note, there remains a low quality evidence for the management of N&V. One prospective study demonstrated that 89% of patients with advanced cancer had vomiting controlled at 1 week (and 56% had nausea controlled at 1 week) after following an aetiology-based approach to management.…”

Section: Treatmentmentioning

confidence: 99%

“…A trial of parenterally administered corticosteroids may be considered alongside antiemetics and antisecretory agents, and the response should be reviewed after 5 days. 8 The review by Walsh et al recommends the use of octreotide and/or an anticholinergic agent in addition to an antiemetic. 11…”

Section: Treatmentmentioning

confidence: 99%

“…Key emetogenic pathways 4,8. Ach = Acetylcholine receptor; CTZ = chemoreceptor trigger zone; D2 = dopamine type 2 receptor; GABA = gammaaminobutyric acid receptor; H1 = histamine type 1 receptor; ICP = intracranial pressure; NK1 = neurokinin 1 receptor; 5HT2 = serotonin type 2 receptor; 5HT3 = serotonin type 3 receptor; 5HT4 = serotonin type 4 receptor.…”

mentioning

confidence: 99%

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Nausea and vomiting in palliative care

Leach

2019

Clinical Medicine

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Table 1 outlines common causes and examples of N&V. It should be noted that many patients in this study had more than a single cause for their N&V. 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. Aetiology In clinical practice, N&V are often multi-factorial symptoms. According to Stephenson et al , the causes in their study were impaired gastric emptying (44%); chemical causes (33%); visceral/serosal pathology (31%); cranial causes (8%) and cortical reasons (7%). 4

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“…Furthermore, N&V can result in significant physical complications including dehydration, electrolyte derangement and malnutrition. 8…”

Section: Clinical Featuresmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

mentioning

confidence: 99%

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Nausea and vomiting in palliative care

Leach

2019

Clinical Medicine

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“…Implications: Interventions are needed to identify patients at risk of late transitions, and to enhance communication and care coordination before, during, and after healthcare transitions. Background: Nausea is a distressing symptom in PC and is often multifactorial in etiology (21). Haloperidol helps nausea through its potent D2 receptor antagonism, yet insufficient evidence exists for the effectiveness of haloperidol for nausea or vomiting in PC.…”

Section: Introductionmentioning

confidence: 99%

Updates in Hospital Palliative Care

Havyer¹,

Abedini²,

Jayes³

et al. 2019

Am J Hosp Med

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Background: This review critiques recent palliative care (PC) literature with likelihood of impacting general hospital practice in order to help address the PC needs of patients. Methods:Articles published between January and December 2018 were identified through handsearch of leading PC journals and MEDLINE search. The final ten selected articles were determined by consensus based on scientific rigor, relevance to general hospital medicine, and impact to practice.Results: Key findings include: Early PC interventions reduced healthcare costs; Prognostic awareness of surrogates of patients with advanced dementia was associated with reduced burdensome interventions; Care transitions, especially in the last 3 days of life, can be detrimental to caregivers' well-being and perceptions of care; Haloperidol was effective for treatment of nausea and vomiting without untoward effects; Antipsychotics did not improve delirium symptoms in hospitalized patients; A fan directed to the face improved dyspnea; Disparities in advance directive completion disappeared when equal opportunities were given; Improving communication with families of critically ill patients improved perceptions of patient-centered care; Communication-priming tools improved the quality and documentation of goals of care conversations; Discussing prognosis did not harm the patient-provider relationship. AJHM Volume 3 Issue 4 (Oct-Dec 2019) REVIEW ARTICLE Havyer et al. www.ajhm.org 2 Conclusion: Recent PC research affirmed the importance of PC delivery to patients with lifelimiting illness and provided important guidance to hospitalists on symptom management, advance care planning, and communication.

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Palliative Care in Patients with Cutaneous Malignancies

Castro

Borges

2023

Oncodermatology

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Nausea and vomiting in palliative care

Cited by 24 publications

References 38 publications

Nausea and vomiting in palliative care

Nausea and vomiting in palliative care

Updates in Hospital Palliative Care

Palliative Care in Patients with Cutaneous Malignancies

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