Forum.
INTRODUCTION/BACKGROUND
The palliative care approach generally provides satisfactory symptom relief for most patients with advanced life-threatening disease. However, patients can experience persistent distressing physical or psychological symptoms, e.g. pain, agitated delirium, severe anxiety or fear in the last days of life. The usual treatment approaches may be ineffective and/or associated with intolerable undesirable effects. In this situation, psychotropic or sedative drugs are used to alter a patient’s psychological state in order to relieve their distress although frequently at the expense of altering the consciousness level. The drugs used in this situation can be classified as:
- anxiolytic sedatives, e.g. midazolam, lorazepam
- antipsychotics (neuroleptics), e.g. haloperidol, levomepromazine (North America: methotrimeprazine)
- sedative anti-epileptics, e.g. phenobarbital
- general anaesthetics, e.g. propofol.
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