nalorphine and Pulmonary-Disease--Chronic-Obstructive

Therapy and the handling of dyspnea in the last period of one's life is described and discussed from a case report. A patient with lung cancer and a distinct chronic obstructive pulmonary disease is presented. His coping with increasing dyspnea and the therapeutic strategies are described. Problems with the side effects of therapy and coping strategies are dealt with, too.

Topics: Adaptation, Psychological; Carcinoma, Squamous Cell; Disease Progression; Dose-Response Relationship, Drug; Drug Combinations; Dyspnea; Humans; Lung Neoplasms; Male; Middle Aged; Morphine Derivatives; Nalorphine; Palliative Care; Pulmonary Disease, Chronic Obstructive; Sick Role; Terminal Care

On the basis of a case study, the complex problems of the final stages of a COPD will be demonstrated and discussed. Dyspnea and anxiousness are the primary symptoms. If they can be adequately brought under control by opiates and benzodiazepines, a palliative sedation is then not necessary. The communicative and ethical demands on the team responsible are high. It is important to be aware of the specific needs of the patient and of his/her family members, and to competently accompany the patient throughout the decision-making process--such as the decision to end respiratory therapy, for example. Clarifying the situation with the patient and finding out his/her wishes, accompanied by the corresponding documentation, is advisable.

Topics: Aged; Anxiety; Conscious Sedation; Continuous Positive Airway Pressure; Drug Combinations; Ethics, Medical; Humans; Male; Medical Futility; Morphine; Morphine Derivatives; Nalorphine; Pain; Palliative Care; Pulmonary Disease, Chronic Obstructive; Terminal Care; Treatment Refusal