Treatment

Treatment

* The clinicians should treat the underlying causes of breathlessness

* The risk benefit of all treatment should always be considered and explained to the patient and their family.

* In patients with congestive heart failure, the simple use of appropriate doses of diuretics may be all that is needed to relieve the respiratory discomfort. The drainage of a large pleural effusion, even if partial, may dramatically improve the patient’s dyspnea.

* For patients with cancer, palliative chemotherapy and radiotherapy, when feasible, are often included as part of the therapeutic regimen.

* Radiotherapy and endobronchial laser treatment may help to shrink the tumor to the point where it no longer causes obstruction.

* Long-term oxygen therapy has been shown to have a beneficial effect on patients with chronic obstructive pulmonary disease (COPD).

* The decision when to use chronic oxygen therapy lies in determining when the patient is hypoxemic.

* A mixture of helium and oxygen is occasionally used to relieve the respiratory distress of patients with severe stridor caused by tracheal obstruction. The patient should be advised that this therapy is known to change the pitch of the voice.

Opioid Analgesics

* Used as: “as needed” schedule and taken orally, parentally or via nebulization

Benzodiazepines

* Used for the treatment of dyspnea in dying patients

Corticosteroids

* Used in the management of bronchospasm of asthma and COPD.

* Also used in the management of superior vena cava syndrome and for the treatment of dyspnea associated with carcinomatous lymphangitis.

Bronchodilator Treatment

* Patients with terminal cancer and dyspnea have a prior history of COPD and it is known that there is a strong association between airflow obstruction and the sensation of shortness of breath.

Xanthines

* Act to enhance respiratory muscle contractility

* Those...