Articles: palliative-care.
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The recommended weekly dose and the maximum tolerated weekly dose of docetaxel (Taxotere; Rhône-Poulenc Rorer, Antony, France) have yet to be determined. We report that a weekly dose of up to 40 mg/m2 docetaxel for 6 weeks is active in pretreated patients with metastatic breast cancer. From a preliminary study, this dose-dense schedule appears to induce less hematologic toxicity than a schedule of 100 mg/m2 every 3 weeks while achieving similar response rates and may represent a valuable alternative involving a shorter treatment time in the palliative therapy of advanced disease in higher-risk patients. The dose-dense weekly administration of paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) also appears to be active, although the toxicity profiles of the two taxanes may differ.
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J Pain Symptom Manage · Oct 1998
Case ReportsOndansetron in nausea and vomiting induced by spinal morphine.
Nausea and vomiting induced by opioids are relatively frequent in advanced cancer patients, although other factors may play a role. These effects, which tend to disappear after repeated dosing, can usually be controlled with antiemetic drugs, including metoclopramide, haloperidol, and phenothiazines. Occasionally, nausea and vomiting persist, in spite of the prolonged administration of the antiemetic treatment. We report a patient who had nausea and vomiting that was resistant to common antiemetic treatments, change in opioid drugs, and change in route of administration, and who had a complete and immediate response to parenteral or oral ondansetron.
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With specialist palliative care services becoming widespread, and the place of the GP in palliative care being examined, audit of patient care delivered by GPs is required in order to ensure adequate standards of care. ⋯ Quality assurance mechanisms present in an in-patient palliative care setting appear to be associated with high-quality care by GPs.
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Palliative care has been described as the active total care of patients whose disease is not responsive to curative treatment. The principles of palliative care are applicable to patients living with non-malignant disease such as end stage renal failure. This paper describes the development of standards of palliative care in a renal care setting. It emphasises the need for a multidisciplinary basis for palliative care and specifies standards of practice in six core areas: Assessment and Referral, Pain and Symptom Control, Communication and giving information, Sexuality, Spirituality and Bereavement.