Initial Palliative Care Drugs' Side Effect

Introduction

The initial palliative care includes pharmacological palliative treatment of pain, depression, anxiety, delirium, nausea and dyspnea. Objective: To study the drugs administered to oncologic patients in initial palliative care and its possible side effects. Methods: This retrospective study included 40 oncologic patients with mean age of 69+14.12 under initial palliative care. Results: Opioids, benzodiazepines, neuroleptics, non-steroidal anti-inflammatory drugs (NSAID), corticosteroids had been prescribed in initial palliative care. Opioids such as fentanyl 0.007 mg/kg/day (3.3%), meperidine 0.64 mg/kg/day (3.3%), tramadol 7.4 mg/kg/day (3.3%), methadone 0.2 mg/kg/day (6.70%) and morphine 0.05 mg/kg/day (70.0%) were given for pain control. For anxiolytic and sedative effects, benzodiazepines such as bromazepam 0.092 mg/kg/day (3.3%), diazepam 0.31 mg/kg/day (3.3%), lorazepam 0.012 mg/kg/day (6.7%), alprazolam 0.006 mg/kg/day (6.7%), midazolam 0.014mg/kg/day (13.0%), clonazepam 0.67 mg/kg/day (20.0%), were administered. Levomepromazine 0,65 mg/kg/day (6,70%), quetiapine 0,25mg/kg/day (6,7%), haloperidol 0,06 mg/kg/day (26,7%), chlorpromazine 0,13 mg/kg/day were the neuroleptics prescribed for delirium/hallucination. In pain adjuvant therapy, NSAID such as dipyrone 3.7 mg/kg/day (90.00%), ketoprofen 2.7 mg/kg/day (6.70%) and tenoxicam 0.79mg/kg/day (3.3%) were administered. To treat nausea/vomiting dexamethasone 0.11 mg/kg/day was given to 53.40% patients. Constipation (66,60%), urinary retention (33,30%), nausea/vomiting (33,30% and hypotension (16,60%), motor agitation (33,30%) were described in this study as pharmacological side effects. Conclusions: Drug-related agranulocytosis and hypotension should be observed with the administration of dypirone. Respiratory depression with the association of opiods and benzodiazepines; extrapyramidal side effect (akathisia) due to administration of neuroleptics and dexamethasone immunosuppression should be considered in these patients’ drug prescription.