For managing nausea in palliative care: Assess for likely causes such as medications, recent chemotherapy, biochemical causes, or gastrointestinal motility disorders, and discuss treatment options with the patient and their carers NICE NG31.
Consider non-pharmacological methods for treating nausea and vomiting in the last days of life NICE NG31.
When choosing medicines, consider the likely cause, side effects, other symptoms, drug interactions, and patient preferences NICE NG31.
Use the most appropriate route of administration, such as subcutaneous or intravenous injections if oral intake is not tolerated NICE NG31.
Start with the lowest effective dose and titrate as needed, with regular reassessment of symptoms NICE NG31.
For managing breathlessness in palliative care: Identify and treat reversible causes such as pulmonary oedema or pleural effusion NICE NG31.
Consider non-pharmacological management, including breathing control and psychosocial support, delivered by a multidisciplinary team NICE NG31.
Do not routinely start oxygen therapy; only offer it to those with symptomatic hypoxaemia NICE NG31.
Manage breathlessness with opioids, benzodiazepines, or a combination of both, considering off-label use in this context NICE NG31.