CURRENT Diagnosis &Treatment: Family Medicine, 5e >Hospice &Palliative Medicine

Jeannette E. South-Paul, Samuel C. Matheny, Evelyn L. Lewis+

Table 67–10.Drugs used to control symptoms in the dying patient.

Symptom Drug Class Drug Route Dose

IV/SC 15–30 mg every 6 hours

NSAID Ketorolac
Pain IV/SC 4 mg every 4 hours
Opioid Morphine
PO/PR 15 mg every 4 hours

Scopolamine TD 1 patch every 3 days

Atropine IV/SC 0.2–0.4 mg every 2 hours

“Death rattle” Anticholinergic
Glycopyrrolate IV/SC 0.2 mg every 4 hours

Hyoscyamine SL 0.125–0.25 mg every 4 hours

IV/SC 4 mg every 4 hours

Dyspnea Opioid Morphine
PO/PR 15 mg every 4 hours

Midazolam SC 2–5 mg every 2 hours

Restlessness/anxiety Benzodiazepine
Lorazepam IV/SC/SL 0.5–1.0 mg every 4 hours

IV/SC 1–2 mg every ½ hour to effect

Haloperidol
Agitation/hallucinations Antipsychotic IV 12.5–25 mg every 6 hours
Thorazine
PR 25–50 mg every 6 hours

IV, intravenous; NSAID, nonsteroidal anti-inflammatory drug; PO, oral; PR, per rectum; SC, subcutaneous; SL, sublingual; TD, transdermal.

Date of download: 12/27/22 from AccessMedicine: accessmedicine.mhmedical.com, Copyright © McGraw Hill. All rights reserved.