NewsLine - July 2013 - (Page 20)

continued from previous page The most amazing thing to me isn’t that we were able to help this one person. Rather, what has amazed me is that he was the first of many patients for whom the hospice team did things others thought impossible, and did so on a routine basis. Treatments In addition to maximizing disease-specific medical treatments as I note above, let’s turn our attention to two of the main classes of medications we use for the palliation of dyspnea — anti-anxiety medications and the opiates. Anti-anxiety Medications Benzodiazepenes are the most common medications used to treat acute bouts of anxiety. Two oft-used members of this drug class include lorazepam (e.g. Ativan) and alprazolam (e.g. Xanax). This class deserves special attention as it is often the first medication used by nonhospice professionals to treat the anxiety caused by dyspnea and the type we often encounter when patients are referred to hospice. In this population, however, these medications are at best variably helpful. 20 NewsLine Opiates As research has borne out, the opiates (such as morphine) are the medication of choice for the symptomatic relief of dyspnea. Furthermore, when used for dyspnea, they often help alleviate the associated anxiety. At doses usually lower than those needed to alleviate pain, the opiates alleviate the sensation of dyspnea without affecting breathing rates. So, if not specifically an antianxiety medication, how do the opiates help treat anxiety? Think about why the patient is anxious in the first place. If we remove the source of the anxiety itself (i.e. the dyspnea), the anxiety will also be treated. So, for patients who feel anxiety because they can’t catch their breath, if we take away their breathlessness, their anxiety will be alleviated too. Additionally, don’t be surprised if your non-hospice colleagues express skepticism or even outright resistance to using opiate medications. There is a widely held belief that these medications are inappropriate or dangerous in this population due to concern that they will depress or even stop a patient’s breathing. As with any powerful medication used in a medically

Table of Contents for the Digital Edition of NewsLine - July 2013

Counseling for Better Quality of Life  
A Message From Don
Funeral Service in America
ehospice USA (display ad) 
Simione Consulting (display ad)  
FHSSA: From Kansas City to Africa (display ad)
Managing Dyspnea  
Lighthouse of Hope Fund (display ad)
New Tip Sheets on Pain
Supporting Fathers and Other Males 
Member News 
Compliance Tip  
Innovation and Excellence at CTC (display ad)
Videos Worth Watching
Links to Resources on the NHPCO Website 

NewsLine - July 2013

https://www.nxtbook.com/mercury/nhpco/NewsLine_Winter2020
https://www.nxtbook.com/mercury/nhpco/NewsLine_Fall2020
https://www.nxtbook.com/mercury/nhpco/NewsLine_Summer2020
https://www.nxtbook.com/mercury/nhpco/NewsLine_Spring2020
https://www.nxtbook.com/mercury/nhpco/NewsLine_Winter2019
https://www.nxtbook.com/mercury/nhpco/NewsLine_Fall2019
https://www.nxtbook.com/mercury/nhpco/NewsLine_Summer2019
https://www.nxtbook.com/mercury/nhpco/NewsLine_Spring2019
https://www.nxtbook.com/mercury/nhpco/NewsLine_Winter2018
https://www.nxtbook.com/mercury/nhpco/NewsLine_Fall2018
https://www.nxtbook.com/mercury/nhpco/NewsLine_Summer2018
https://www.nxtbook.com/mercury/nhpco/NewsLine_Spring2018
https://www.nxtbook.com/mercury/nhpco/NewsLine_Winter2017
https://www.nxtbook.com/mercury/nhpco/NewsLine_Fall2017
https://www.nxtbook.com/mercury/nhpco/NewsLine_Summer2017
https://www.nxtbook.com/mercury/nhpco/NewsLine_Spring2017
https://www.nxtbook.com/mercury/nhpco/NewsLine_2016Winter
https://www.nxtbook.com/mercury/nhpco/NewsLine_2016Fall
https://www.nxtbook.com/mercury/nhpco/NewsLine_2016Summer
https://www.nxtbook.com/mercury/nhpco/NewsLine_2016Spring
https://www.nxtbook.com/mercury/nhpco/NewsLine_2015Winter
https://www.nxtbook.com/mercury/nhpco/NewsLine_2015Fall
https://www.nxtbook.com/mercury/nhpco/NewsLine_2015Summer
https://www.nxtbook.com/mercury/nhpco/NewsLine_2015Spring
https://www.nxtbook.com/mercury/nhpco/NewsLine_2014Winter
https://www.nxtbook.com/mercury/nhpco/NewsLine_2014Fall
https://www.nxtbook.com/mercury/nhpco/Newsline_201406
https://www.nxtbook.com/mercury/nhpco/Newsline_201405
https://www.nxtbook.com/mercury/nhpco/newsline_201404
https://www.nxtbook.com/mercury/nhpco/newsline_201403
https://www.nxtbook.com/mercury/nhpco/newsline_201402
https://www.nxtbook.com/mercury/nhpco/newsline_201401
https://www.nxtbook.com/mercury/nhpco/newsline_201312
https://www.nxtbook.com/mercury/nhpco/newsline_201311
https://www.nxtbook.com/mercury/nhpco/Newsline_201310
https://www.nxtbook.com/nxtbooks/nhpco/newsline_201309
https://www.nxtbook.com/nxtbooks/nhpco/newsline_201308
https://www.nxtbook.com/nxtbooks/nhpco/newsline_201307
https://www.nxtbook.com/nxtbooks/nhpco/newsline_201306
https://www.nxtbook.com/nxtbooks/nhpco/newsline_201305
https://www.nxtbook.com/nxtbooks/nhpco/newsline_201304
https://www.nxtbook.com/nxtbooks/nhpco/newsline_201303
https://www.nxtbook.com/nxtbooks/nhpco/newsline_201302
https://www.nxtbook.com/nxtbooks/nhpco/newsline_201301
https://www.nxtbook.com/nxtbooks/nhpco/newsline_201212
https://www.nxtbook.com/nxtbooks/nhpco/newsline_201211
https://www.nxtbook.com/nxtbooks/nhpco/newsline_201210
https://www.nxtbook.com/nxtbooks/nhpco/newsline_201209
https://www.nxtbook.com/nxtbooks/nhpco/newsline_201208
https://www.nxtbook.com/nxtbooks/nhpco/newsline_201207
https://www.nxtbook.com/nxtbooks/nhpco/newsline_201206
https://www.nxtbook.com/nxtbooks/nhpco/newsline_201205
https://www.nxtbook.com/nxtbooks/nhpco/newsline_201204
https://www.nxtbook.com/nxtbooks/nhpco/newsline_201203
https://www.nxtbook.com/nxtbooks/nhpco/newsline_201202
https://www.nxtbook.com/nxtbooks/nhpco/newsline_201201
https://www.nxtbook.com/nxtbooks/nhpco/newsline_201112
https://www.nxtbook.com/nxtbooks/nhpco/newsline_201111
https://www.nxtbook.com/nxtbooks/nhpco/newsline_201110
https://www.nxtbook.com/nxtbooks/nhpco/newsline_201109
https://www.nxtbook.com/nxtbooks/nhpco/newsline_201108
https://www.nxtbook.com/nxtbooks/nhpco/newsline_201107
https://www.nxtbook.com/nxtbooks/nhpco/newsline_201106
https://www.nxtbook.com/nxtbooks/nhpco/newsline_201105
https://www.nxtbook.com/nxtbooks/nhpco/newsline_201104
https://www.nxtbook.com/nxtbooks/nhpco/newsline_201103
https://www.nxtbook.com/nxtbooks/nhpco/newsline_201102
https://www.nxtbook.com/nxtbooks/nhpco/newsline_201101
https://www.nxtbook.com/nxtbooks/nhpco/newsline_201012
https://www.nxtbook.com/nxtbooks/nhpco/newsline_201011
https://www.nxtbook.com/nxtbooks/nhpco/newsline_201010
https://www.nxtbook.com/nxtbooks/nhpco/newsline_201009
https://www.nxtbook.com/nxtbooks/nhpco/newsline_201008
https://www.nxtbook.com/nxtbooks/nhpco/newsline_201007
https://www.nxtbook.com/nxtbooks/nhpco/newsline_201006
https://www.nxtbook.com/nxtbooks/nhpco/newsline_201005
https://www.nxtbook.com/nxtbooks/nhpco/newsline_201004
https://www.nxtbook.com/nxtbooks/nhpco/newsline_201003
https://www.nxtbook.com/nxtbooks/nhpco/newsline_201002
https://www.nxtbook.com/nxtbooks/nhpco/newsline_201001
https://www.nxtbookmedia.com