The use of prokinetic drugs in palliative care
Robert Twycross
pp 143-145
Prokinetic drugs are drugs that accelerate gastrointestinal transit by a neurohumoral mechanism. Traditionally, the term has been restricted to drugs that co-ordinate antroduodenal contractions and accelerate GI transit (Tables 1 and 2).
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Opioid-induced myoclonus
Juan M Núnez Olarte
pp 146-150
Multifocal myoclonus has long been recognised as a side-effect of chronic high-dose opioid therapy. In the light of recent knowledge about the possible role of morphine (and other opioid) metabolites in the genesis of these abnormal limb movements, there is a growing interest in these phenomena. The development of the concept of the ‘opioid hyperexcitability syndrome’ has added impetus to the research on opioid-induced myoclonus, due to the theoretical potential of myoclonus to become a specific marker of opioid-induced toxicity.
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Endocrine therapy in advanced malignancy
Janet Hardy
pp 151-154
Hormonal therapy has specific as well as non-specific benefits for the cancer patient. Non-specific benefits include the stimulation of appetite with progestogens and the improvement of appetite and general well-being with corticosteroids. This article concentrates on the specific use of hormones as palliative therapy in advanced, incurable malignancy.
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Pain therapy in Pancoast’s syndrome
Lucie Hacpille
pp 155-160
This tumour, described by Pancoast in 1924, causes pain at C8, D1 and D2, muscular atrophy in the region of the ulnar nerve and destruction of the ribs. For a long time, treatment has been unsatisfactory.
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Skill and attributes of doctors in palliative medicine: a study
Linda Jenkins
pp 161-165
A significant turning point in the out-growth of palliative care from the hospice movement in the UK has been the development of palliative medicine as a recognised specialty in medicine. In December 1987, the UK Joint Committee on Higher Medical Training approved the introduction of an accredited training programme for doctors in palliative medicine. This led to the design of a four-year senior registrar training programme, including two years in one or more specialist units.
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Ethical problems in nursing the terminally ill
Chris Bassett
pp 166-168
Ethical and moral decisions, often highly complex, must frequently be taken when caring for terminally ill patients. Few other areas of nursing are as demanding, in terms of both professional expertise and the ability to cope ethically. Holsclaw describes nurses as often having to cope with ‘emotional assaults on the professionalised self concept’. This view is widely supported in the literature.
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The quality of terminal care in haematology
Jean Michel Laussanière and Gilles Auzanneau
pp 169-172
The first World Congress on Palliative Care in Haematology (held in Tours, France, in late 1994) brought together professionals from two specialties: l Haematology – biological, technical and academic. l Palliative care – focusing on the suffering of the patient at the end of life.
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