Long-term subcutaneous infusion of midazolam for refractory delirium in terminal breast cancer.
We describe the case of a 56-year-old woman with terminal metastatic breast cancer who had delirium in the form of frightening hallucinations, paranoid delusions, and nightmares resulting in violent agitation. During this period, her bone pains from metastases were well controlled with narcotic analgesics, but her delirium proved refractory to standard doses of drugs such as lorazepam, diazepam, and haloperidol. We report the use of a subcutaneous infusion of midazolam at home and its effectiveness in control of her delirium after other drugs had failed.
Ramani
S
S
Department of Internal Medicine, Alvin C. York Veterans Affairs Medical Center, Murfreesboro, Tenn, USA.
Karnad
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AB
D001859:Bone Neoplasms / Q000150:complications* / Q000556:secondary*; D001943:Breast Neoplasms / Q000473:pathology*; D003693:Delirium / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D006699:Home Care Services; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D007263:Infusions, Parenteral; D008874:Midazolam / Q000627:therapeutic use*; D008875:Middle Aged; D012008:Recurrence; D013727:Terminal Care; D016896:Treatment Outcome
D006993:Hypnotics and Sedatives; D008874:Midazolam