Purpose | Principles | How to Care for a Patient in Pain | Nutrition
Nausea and Vomiting | Constipation | Anxiety and Depression | Dyspnea
Fatigue | End-of-Life Decision-Making | Community Resources
How to Refer Patients | Communication | Links and References
Dyspnea is the unpleasant awareness of difficulty in breathing.
Dyspnea Notes
-
Breathlessness is measured by tachypnea (increased respiratory rate), hyperpnea (increased depth of respiration), oxygen saturation, blood gas levels
-
Anxiety may prevent patient from accurately reporting dyspnea
-
Patient and family members tend to focus on observed breathlessness or tachypnea, adding to their anxiety
Managing Dyspnea
Pharmacologic Management of Dyspnea
| Drug |
Dose |
Interval |
Route |
Side Effects |
| Albuterol |
2-4 mg |
3-4 times/day |
nebulizer |
tremors
nausea
bronchospasm
nervousness |
Xopenex
(levalbuterol HCL) |
0.63 mg |
3 times/day |
nebulizer |
tremors
nausea
bronchospasm
nervousness |
Atrovent
(ipratropium) |
500 mcg |
3-4 times/day |
nebulizer |
nervousness
bronchospasm
dry mouth
headache |
Solumedrol
(methyprednisolone) |
10-80 mg |
3-4 times/day |
IV |
GI upset
psychosis
hyperglycemia |
Xanax
(alprazolam) |
0.5-4 mg |
3-4 times/day |
oral |
drowsiness
ataxia
sedation
confusion |
Ativan
(lorazepam) |
0.5-2.0 mg |
2-3 times/day |
IV
oral
sublingual |
sedation
confusion
repiratory depression |
Thorazine
(chlorpromazine) |
5-10 mg |
3-4 times/day |
IV
oral |
over-sedation
especially with morphine |
Roxanol
(morphine sulfate) |
5-30 mg |
6-8 times/day |
sublingual |
somnolence
hypotension
constipation |
Non-Pharmacologic Management of Dyspnea
- Oxygen 2-6 L/min via nasal cannula or venturi mask where appropriate
- Eliminate alarms and oximeters, if possible
- Educate family members and caregivers of breathing patterns to prevent family anxiety
- Minimize loneliness, provide spiritual support, address family and patient needs
- Coordinate treatments with family and other caregivers; explain interventions
- Use fans, cool cloths to face; establish slow, controlled breathing
- Re-position patient, try high Fowler's position or lean forward with upper arms supported on table; pursed lip breathing
Cancer Education & Information Center | 3015 N. Ballas Road | St. Louis, Missouri 63131 USA | 314.996.5800