Nebulized Morphine and the Management of Terminal Dyspnea

8/23/98


Click here to start


Table of Contents

Nebulized Morphine and the Management of Terminal Dyspnea

Introduction

Terminal dyspnea often does not respond to standard therapy

Etiology of Dyspnea in Terminal Patients

Direct Tumor Effects

Indirect Tumor Effects

Treatment Related Causes

Problems unrelated to terminal diagnosis

Diagnosis

Diagnostic Tests

Treat specific cause of dyspnea if possible (or indicated)

Nonspecific dyspnea therapy

O2 Therapy in hypoxemic patients

Oxygen in non-hypoxemic patients

Opioid therapy in terminal dyspnea

Change in perception of dyspnea after SC MSO4

Benzodiazepines in Dyspnea

Continuous infusion of MSO4

Local Anesthetic Aerosols

Nebulized Morphine: Pharmacokinetics

Efficacy

Interesting Effects

Farncombe Efficacy Study

Noseda Study

Administration of nebulized opioids

Contraindications

Case Report

Case report (continued)

Author: Steven J Baumrucker, MD

Email: author@xtn.net

Home Page: http://xtn.net/~author/hospice.htm