Seizures in palliative medicine: brivaracetam

Seizures occur in around 13% of patients with cancer and can be distressing for family members to witness. In those unable to manage regular antiepileptic medications, midazolam can be administered subcutaneously using a syringe driver, but this may cause sedation. Brivaracetam is a newer drug licensed as an adjunctive therapy in the treatment of partial-onset seizures with or without secondary generalisation and for restricted use in those with refractory epilepsy. It is associated with fewer behavioural or psychiatric side effects than levetiracetam, has a very low incidence of drug interactions and the maximal dose can be accommodated in a single syringe driver. We present three cases from 2019 to 2020 where subcutaneous brivaracetam has been successfully used in a Specialist Inpatient Palliative Care setting to manage seizures. Brivaracetam dosing is 1:1 conversion from oral:subcutaneous, with syringe driver doses ranging from 150 mg to 300 mg/24 hours being successfully used, with no adverse effects observed.

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Tolerability of Continuous Subcutaneous Octreotide Used in Combination with Other Drugs

Journal of Palliative Care ◽

10.1177/082585979501100403 ◽

1995 ◽

Vol 11 (4) ◽

pp. 14-16 ◽

Cited By ~ 12

Author(s):

Sebastiano Mercadante

Keyword(s):

Care Setting ◽

Symptom Control ◽

Clinical Situation ◽

Oral Route ◽

Advanced Cancer Patients ◽

Good Tolerability ◽

Subcutaneous Infusion ◽

Palliative Care Setting ◽

Syringe Driver ◽

Drug Precipitation

Continuous subcutaneous infusion of octreotide combined with other drugs has proved to be useful in some circumstances in palliative care setting when the oral route is no longer available. Forty-four patients were administered octreotide alone or in combination with other drugs in the same syringe driver for symptom control in advanced cancer patients. Good tolerability and compatibility were observed without visual drug precipitation for a period of 48 hours at room temperature, the standard clinical situation in patients’ homes. Such a combination of drugs administered by the subcutaneous route makes possible the’ adequate control of symptoms in the final days of life.

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Symptom clusters in patients with cancer in the hospice/palliative care setting

Supportive Care in Cancer ◽

10.1007/s00520-016-3210-6 ◽

2016 ◽

Vol 24 (9) ◽

pp. 3863-3871 ◽

Cited By ~ 10

Author(s):

Stephen J. Stapleton ◽

Janean Holden ◽

Joel Epstein ◽

Diana J. Wilkie

Keyword(s):

Palliative Care ◽

Care Setting ◽

Symptom Clusters ◽

Patients With Cancer ◽

Palliative Care Setting ◽

Hospice Palliative Care

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Pattern of Hospitalization of Patients With Cancer in an Acute Palliative Care Setting

American Journal of Hospice and Palliative Medicine® ◽

10.1177/1049909112439931 ◽

2012 ◽

Vol 30 (1) ◽

pp. 25-28 ◽

Cited By ~ 4

Author(s):

Sadeer G. Al-Kindi ◽

Ghaith F. Abu Zeinah ◽

Azza Adel Hassan

Keyword(s):

Palliative Care ◽

Care Setting ◽

Average Length ◽

Wealthy Country ◽

Gastrointestinal Malignancies ◽

Patients With Cancer ◽

Average Length Of Stay ◽

Palliative Care Setting ◽

Specialized Palliative Care ◽

Palliative Care Units

Palliative care is an essential part of in cancer treatment. Specialized palliative care units are starting to be incorporated into advanced healthcare systems. Qatar, a wealthy country in the Middle East, opened its first acute palliative care unit within a specialty cancer hospital in 2008. The objective of this study is to report and analyze the patterns of admissions and discharges of the patients referred to this unit over a period of three years. Our unit received 241 total admissions from July 2008 to June 2011. The age of the patients was 60.5 years, with 41.6% being local Qataris. Gastrointestinal malignancies formed the most common (34.5%). The average length of stay per admission at this unit was 30.5 days. The in-hospital mortality in our unit was 61.7%. The LOS and mortality rates were higher than those reported in the literature. We attributed that to the lack of other models of palliative care in the country and to cultural factors.

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Meeting the social, emotional and psychological needs of patients in a cancer palliative care setting: Student Nurses� experiences from Karachi, Pakistan

i-manager’s Journal on Nursing ◽

10.26634/jnur.1.1.1364 ◽

2011 ◽

Vol 1 (1) ◽

pp. 38-43

Author(s):

Nasreen Sulaiman Lalani ◽

◽

Shabana D. Lakhani ◽

Muslim Shah ◽

◽

...

Keyword(s):

Palliative Care ◽

Care Setting ◽

Student Nurses ◽

Psychological Needs ◽

Social Emotional ◽

The Social ◽

Palliative Care Setting

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Validation of the Phase II Feasibility Study in a Palliative Care Setting

American Journal of Hospice and Palliative Medicine® ◽

10.1177/1049909112471422 ◽

2012 ◽

Vol 30 (8) ◽

pp. 752-758 ◽

Cited By ~ 9

Author(s):

Cindy Lee ◽

Ryash Vather ◽

Anne O’Callaghan ◽

Jackie Robinson ◽

Briar McLeod ◽

...

Keyword(s):

Palliative Care ◽

Feasibility Study ◽

Phase Ii ◽

Care Setting ◽

Palliative Care Setting

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Outcome measures for holistic, complex interventions within the palliative care setting

Complementary Therapies in Clinical Practice ◽

10.1016/j.ctcp.2007.10.001 ◽

2008 ◽

Vol 14 (1) ◽

pp. 25-32 ◽

Cited By ~ 12

Author(s):

Elizabeth Anita Thompson ◽

Tina Quinn ◽

Charlotte Paterson ◽

Helen Cooke ◽

Deidre McQuigan ◽

...

Keyword(s):

Palliative Care ◽

Outcome Measures ◽

Care Setting ◽

Complex Interventions ◽

Palliative Care Setting

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Bereaved spouses' adjustment after the patients' death in palliative care

Palliative & Supportive Care ◽

10.1017/s1478951507000594 ◽

2007 ◽

Vol 5 (4) ◽

pp. 397-404 ◽

Cited By ~ 24

Author(s):

Maria E. Carlsson ◽

Ingrid M. Nilsson

Keyword(s):

Palliative Care ◽

Sleep Disturbance ◽

Care Setting ◽

Significant Decline ◽

First Year ◽

Inclusion Criteria ◽

Life Situation ◽

Palliative Care Setting ◽

Advanced Home Care ◽

Grief Reactions

ABSTRACTObjectives:To improve the support to bereaved spouses during the year after the patient's death, a project was started consisting of three visits by a nurse (after 1, 3, and 13 months) with conversations about the patient's death and the spouse's life situation. The aim of this study was to describe the bereaved spouse's situation and adaptation during the first year after the loss.Methods:Spouses of patients cared for by The Advanced Home Care Team (APHCT) in Uppsala, Sweden, were invited to participate in the project. Each participant was encouraged to talk freely about his or her situation, but enough direction was given to ensure that all items listed on a standardized questionnaire were covered.Results:Fifty-one spouses met the inclusion criteria and were invited to participate and 45 accepted. The subjects felt quite healthy but were tired and suffered from sleep disturbance. The grief reactions had initially been high but showed a significant decline from 1 to 13 months (p < .01). Forty-nine percent had experienced postbereavement hallucinations.Significance of results:This study showed that the bereaved spouses felt quite healthy and adjusted quite well to their new life situation, after the patient's death in a palliative care setting. The grief reactions had initially been high but showed a significant decline during the year.

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