Nausea and vomiting are unfortunately a common occurrence in palliative care patients. They are debilitating and lower the quality of life in patients and their relatives. Nausea and vomiting are majorly present in malignant conditions but can be present in non-malignant disorders as well. In such cases, palliative care improves end-of-life care. Let’s understand more about palliative care in such patients.
Finding and treating the underlying cause is the first step while managing nausea and vomiting. Some of the common causes are:
The most important aim of palliative care is to improve the quality of life. Medications are not always needed to manage nausea or vomiting. Simple palliative measures to manage them are:
If non-pharmacological measures fail to manage nausea and vomiting, medications are used to manage them. While giving medications, the underlying condition is managed and not just the symptoms.
In the majority of cases, antiemetics are used. Care should be taken to give antiemetic through the best route and the patient should be observed frequently. Antiemetics can be given regularly until the symptoms are resolved.
Various analgesics used to manage pain, such as opioids, can cause nausea and vomiting. Using antiemetic in such cases is often necessary.
Depending on the cause, other medications that can be used to manage nausea and vomiting are:
Depending on the patient’s condition, these medications are administered as liquid doses, topical gel, pills, or suppositories.
Palliative care depends on the efficacy of the previous treatment. If nausea is managed by the current regimen, the same drugs should be given subcutaneously. In cases of new symptoms, the same treatment can be carried out with the removal of cause if any. For uncontrolled nausea and vomiting, levomepromazine is generally preferred as it acts in various ways. The risk of drowsiness is also less.