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Hospice Medications Used for Cancer Patients

May 4, 2011 | By Christy Brogan
Hospice Medications Used for Cancer Patients
Photo Credit medication image by Tom Oliveira from Fotolia.com

The Hospice Foundation of America defines hospice care as a way to provide comfort and enhanced quality of life to those who are terminally ill. Hospice teams specialize in the symptom management that comes along with life-limiting illnesses, such as cancer. Symptoms associated with terminal cancer vary greatly, but common complications include pain, nausea, vomiting, constipation, edema, shortness of breath and infection. The use of medications is essential in keeping symptoms at a minimum, thus, improving quality of life.

Pain Control

In an article published in the November 2005 issue of "The Journal of American Osteopathic Association," Pharo and Zhou reported that up to 80 percent of patients with advanced cancer experience pain from their disease. Many types of medication for pain exist and are chosen based on the location, severity and type of pain. For pain that is mild, medications like ibuprofen (Advil), acetaminophen (Tylenol) and naproxen (Aleve) may be used. When pain is severe, opioid medications may be needed. These medications include codeine, morphine, oxycodone, fentanyl, methadone and hydromorphone. Some medications that are not classified as pain medications are used to treat pain. Steroids, like Decadron, are helpful for pain caused by swelling and bone pain. Some antiseizure medications and antidepressants have been used with other pain medications to successfully treat pain. Common antiseizure medications include Neurontin and Depakote. Antidepressant medications used for pain are amitriptyline, Cymbalta and Effexor.

Nausea and Vomiting

According to the National Cancer Institute, the causes of nausea vary, but cancers of the brain, liver and gastrointestinal tract are particularly known for causing nausea. Chemotherapy and radiation can also cause nausea in cancer patients. Again, the type of nausea medication prescribed depends on the cause. There are several medications that are available for the treatment of nausea. Common medications include Zofran, Reglan, Compazine, Meclizine, Hyoscyamine, Decadron, Kytril, Emend, Marinol, Haldo and Ativan. Nausea medications come in many forms for those who cannot keep pills down due to vomiting. They may be given under the tongue, intravenously, rectally and orally. Certain medications can be made into creams that are rubbed into the skin.

Infection and Fever

Advanced cancer compromises the immune system, making infections and fevers prevalent. Medications, such as Tylenol, Advil and aspirin, may be used to treat fevers. Antibiotics may also be used to treat infections. A study by Vitetta et al, published in "The Journal of Pain and Symptom Management" in 2000, suggests that antibiotics could reduce fevers and infection discomfort in cancer patients. Some commonly used antibiotics for hospice patients include Cipro, Levaquin, Zithromax, amoxicillin, Bactrim and Keflex.

Diuretics for Edema

Edema, or swelling, can occur in the cancer patient for many reasons, such as malnutrition or prior chemotherapy treatments. It can be uncomfortable and, even, painful. Medications that remove fluid from the body are used to help with the discomfort of edema. Diuretics take extra fluids from the body and send them to the filtration system, the kidneys. The fluid is discarded as extra urine. Commonly used diuretics include Lasix, Bumex, Spironolactone, Metalazone and Hydrochlorothiazide.

Shortness of Breath

A study by McMillian and Small, published in the "Oncology Nursing Forum" in 2002, lists shortness of breath as the most common and fear-provoking symptom of cancer patients in hospice. Medications that open airways are frequently used to treat shortness of breath. These drugs include Albuterol, Ipratropium bromide, Xopenex and Advair. Morphine is effective in treating fighting-for-air sensations. Anxiety medications are also often used in therapy of shortness of breath due to the fear associated with breathlessness.

Constipation

Constipation is common in terminally ill cancer patients due to use of opioid pain medications and poor fluid and food intake. It is more likely with certain types of cancer. Medications use to treat constipation have many different actions. Some stimulate the intestines to increase motility, while some pull more water into the intestines. Commonly used medications include senna, Colace, Miralax, Dulcolax, magnesium citrate, lactulose and mineral oil.

References

Article reviewed by Dana Montey Last updated on: May 4, 2011

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