DISTRESSING SYMPTOMS

Symptoms that contribute to the

suffering of a terminally ill patient

1
 FATIGUE
• Tiredness
• Lack of energy not relived by rest
• Diminished mental capacity

2
 CAUSES
 Physical stress
– Disease itself
– Treatment e.g.. antihypertensive, diuretics
 Psychological stress
– Anxiety
– Depression

3
4
 MANAGEMENT
 establish and where possible, treat or remove cause
review the drug regimen
— correct metabolic abnormalities
 give dietary advice/support
— increase caloric intake if appropriate
 exercise
— exercise may be effective particularly in fatigue
caused by radiotherapy
— limited exercise programmes have been shown
to be beneficial even in those close to the end of
life
5
 MANAGEMENT
DRUGS
 Dexamethasone
 Psychostimulants e.g.. Methylphenidate
(Ritalin)
 Antidepressants
 Erythropoietin

6
7
THE END