title: An approach to dyspnea in advanced disease.
abstract: BACKGROUND
  To describe an approach to assessment and treatment of dyspnea.
  
  
  METHODS
  New level I evidence can guide management of dyspnea in advanced illness. Assessment and use of adjuvant medications and oxygen relies on level II and III evidence.
  
  
  RESULTS
  Opioids are first-line therapy for managing dyspnea in advanced illness. They are safe and effective in reducing shortness of breath. Neuroleptics are useful adjuvant medications. Evidence does not support use of oxygen for every patient experiencing dyspnea; it should be tried for patients who do not benefit from first-line medications and nonmedicinal therapies.
  
  
  CONCLUSIONS
  Opioids relieve dyspnea and are indicated as first-line treatment for dyspnea arising from advanced disease of any cause.
authors.affiliation: Department of Family Practice, University of British Columbia, Vancouver. romayne@interchange.ubc.ca
authors.forename: Romayne
authors.initials: R
authors.lastname: Gallagher
mesh_terms: D014150:Antipsychotic Agents / Q000627:therapeutic use*; D004417:Dyspnea / Q000175:diagnosis* / Q000188:drug therapy*; D019317:Evidence-Based Medicine; D006801:Humans; D009294:Narcotics / Q000627:therapeutic use*; D012720:Severity of Illness Index; D013727:Terminal Care
chemical_list: D014150:Antipsychotic Agents; D009294:Narcotics