Key notes on symptom control issues in Palliative Care



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tarix25.12.2016
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Cough





Cough




Step one

Treat reversible causes if possible

Simple linctus

Step two

Small doses of short acting opioids

Nebulised saline

Step three

Trial of steroids

Ask for help




  • Affects up to 90% of lung cancer patients at some point in their cancer journey. Can affect patients with other primary diagnoses such as oesophageal carcinoma and those with metastatic lung involvement, particularly breast cancer.

  • Can be very debilitating particularly if spasmodic.

  • Identify treatable causes such as acute infection, bronchospasm or iatrogenic causes such as ACE-inhibitors. Remember the possibility of cough induced by aspiration or gastro-oesophageal reflux.

  • Consider the use of postural drainage and physiotherapy.




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