Effective pain management in terminal care.

Pharmacologic therapy is the mainstay of pain management in the terminally ill cancer patient. Upwards of 90% of the pain of cancer can be controlled by relatively simple means (i.e. oral, rectal, or transdermal analgesics). More invasive procedures may be needed in a small percentage of patients. Effective management of pain in the elderly requires recognition of age-related changes in drug pharmacokinetics and an awareness of drug side effects that may be particularly problematic in older patients. Careful attention to the basic principles of drug use in the elderly will enhance effective pain management and quality of life.