Towards a basic drug kit for the dying patient.

PURPOSE OF REVIEW

Awareness of palliative care, including knowledge and skills regarding symptom alleviation via pharmacological and non-pharmacological interventions, is limited in many settings. Lists have been published of recommended drugs for palliative care that include medications for different disease stages, using different modes of administration.

RECENT FINDINGS

Recent studies confirm that many of the most common symptoms in dying patients, for example pain, dyspnoea, anxiety, nausea, and delirium, are similar regardless of diagnosis. The classes of drugs most commonly recommended for alleviation of these symptoms are opioids, neuroleptics, benzodiazepines, and antimuscarinic drugs. Other recommendations have the character of emergency kits of standard drugs for common symptoms, to be used when needed in caring for dying patients at home or in hospitals.

SUMMARY

Recommendations for the most appropriate drugs which should be available for the care of dying patients in all settings is suggested to have potential to improve quality of care through increasing the confidence of physicians and nurses, being costeffective, decreasing the need for hospital admissions, and most of all - reducing suffering. Education and training at all levels, as well as further policy work through expert recommendations, care pathways, and media attention, are needed.