[Pharmacological Treatment in End-of-Life Sedation]. / Manejo farmacológico de la sedación paliativa en la agonía.

Objective: To control the physical symptoms in end-of-life pharmacological management involves major intervention. The aim of this article is to review the relevant issues in the management of clinical nursing situation and drugs commonly used in palliative sedation in agony. Methodology: Nursing management in Palliative Sedation recommended by scientific literature search in Scopus, CINAHL, Medline-PubMed and Google Scholar, with key words "palliative sedation", "pharmacology", "nursing care" and "palliative care" are selected. Results: The goal of palliative sedation (PS) is to reduce the level of consciousness as the only way to relieve intense suffering in terminally ill patients, such as refractory delirium or dyspnea, massive bleeding, convulsive status, crackles premortem or refractory psychological suffering. The route of choice in PS is subcutaneous injection (sc). First line drugs in sedation are midazolam and levomepromazina. Opioids should be kept at equi-analgesic doses, morphine chloride being the most widely used. The fundamental role of nursing in SP is monitoring the level of sedation based on the Ramsay scale (or similar) and recognition of the indicative signs of discomfort for administration rescue sedative or analgesic medication and/or screening treatable intercurrent process (distended bladder, constipation, obstruction way, final dose effect, etc.).

[PHARMACOLOGICAL TREATMENT IN PALLIATIVE CARE. DRUG ADMINISTRATION ROUTE, CONTINUOUS SUBCUTANEOUS INFUSION, ADVERSE SIDE EFFECTS, SYMPTOM MANAGEMENT]. / Farmacoogía en Cuidados Paliativos.

OBJECTVE: To achieve well-being in patients in Palliative Care is required to know which are the most common symptoms, which are the drugs used for relief, which are the routes of administration of drugs that are suitable, how effective the drugs are and what incompatibilities, interactions and adverse effects occur. The aim of this article is to review the relevant issues in the management of the drugs commonly used by nursing in Palliative Care and presenting recommendations to clinical practice. METHODOLOGY: Management interventions drugs for nurses in Palliative Care recommended by the scientific literature after a search of Scopus, CINAHL, Medline, PubMed, UpToDate and Google Scholar are selected. RESULTS: The oral route is the choice for patients in palliative situation and subcutaneous route when the first is not available. The symptoms, complex, intense and moody, should be systematically reevaluated by the nurse, to predict when a possible decompensation of it needing extra dose of medication. DISCUSSION: Nurses must be able to recognize the imbalance of well-being and act quickly and effectively, to get relief to some unpleasant situations for the patient as the pain symptoms, dyspnea or delirium. For the proper administration of rescue medication, the nurse should know the methods of symptomatic evaluation, pharmacokinetics and pharmacodynamics of drugs, the time intervals to elapse between different rescues and nccocc rocnnnco t thocm