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Palliative Pearls

Olanzapine (Zyprexa) for Nausea

June 2017 – Olanzapine has “broad spectrum” activity for difficult to treat nausea. Olanzapine has broad activity at dopaminergic and serotonin receptors as well as activity along histaminic...

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Hand-held fan for dyspnea

May 2017 – Treating dyspnea improves function in late stage COPD and CHF. Studies show the use a hand held fan directed to the face reduces dyspnea. Low dose opioids (not only morphine) also red...

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The “Surprise Question”

April 2017 – “The point of prognostication is not to be right, but to help people prepare” – Atul Gawande, M.D. Asking -“Would I be surprised if this patient died in the next yea...

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Dexamethasone After Falls

March 2017 – Frail elders can be disabled for days after a “non-injury fall”. A 7 day dexamethasone burst can improve function, mobility and comfort dramatically, easing pain with respiratio...

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Acetaminophen for Agitation in Dementia

February 2017 – Agitation in dementia may be a result of untreated pain. Use of scheduled acetaminophen has been demonstrated to reduce agitation significantly in nursing home populations of pat...

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