title: Psychotropic drugs for terminally ill patients with respiratory disease.
abstract: Utilization of psychotropic drugs including hypnotics, sedatives, and parenteral morphine for terminally ill patients with respiratory disease has not been reported precisely. To better understand these drugs for dying patients with respiratory disease, we focused on the last month of life of them. A chart review, which was focused on symptoms and managements, in the last month of life of 337 patients who died of respiratory disease between April 2000 and March 2005 were performed. Hypnotics were prescribed in 35.8% and 23.2% of patients with malignant and non-malignant disease, respectively. Sedatives such as haloperidol and midazolam were utilized in 34.4% of patients with malignant disease, and 30.4% of those with non-malignant disease. Sixty-seven percent of patients with malignant and 22.4% of those with non-malignant disease had parenteral morphine. In patients with malignant disease, three of the main reasons for administration of morphine were pain, dyspnea, or terminal restlessness. In all of the patients with non-malignant disease, however, parenteral morphine was prescribed for the treatment of dyspnea. Our results showed that psychotropic drugs and parenteral morphine are required in some of terminally ill patients with respiratory disease. Although careful individualization of medication is appropriate, guideline for the prescribing psychotropic drugs for these patients will be required.
authors.affiliation: Division of Respiratory Medicine, Institute of Clinical Medicine, University of Tsukuba, Tsukuba Medical Center Hospital, Tsukuba, Japan.
authors.forename: Kouji
authors.initials: K
authors.lastname: Kanemoto
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Satoh
authors.forename: Katsunori
authors.initials: K
authors.lastname: Kagohashi
authors.forename: Koichi
authors.initials: K
authors.lastname: Kurishima
authors.forename: Hiroichi
authors.initials: H
authors.lastname: Ishikawa
authors.forename: Morio
authors.initials: M
authors.lastname: Ohtsuka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000627:therapeutic use; D017723:Drug Utilization Review; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D008171:Lung Diseases / Q000150:complications / Q000453:epidemiology*; D008297:Male; D008485:Medical Audit; D008499:Medical Records; D008875:Middle Aged; D009020:Morphine / Q000627:therapeutic use; D010148:Intractable Pain / Q000150:complications / Q000188:drug therapy*; D010166:Palliative Care / Q000379:methods*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D012189:Retrospective Studies; D019452:Terminally Ill; D014421:Turkey / Q000453:epidemiology
chemical_list: D000701:Analgesics, Opioid; D006993:Hypnotics and Sedatives; D011619:Psychotropic Drugs; D009020:Morphine