Palliative Medicine

Cover......Page 1
Preface
......Page 3
International Advisory Board......Page 4
Contributors......Page 5
1 - Palliative Medicine—The Global Perspective: Closing the Know-Do Gap......Page 27
2 - Death in Modern Society......Page 33
3 - Illness Trajectories and Stages......Page 38
4 - The History of Hospice......Page 43
5 - Palliative Medicine: Models of Organization......Page 48
6 - The Specialty of Palliative Medicine......Page 54
7 - Principles of Palliative Medicine......Page 58
8 - The Human Experience of Illness......Page 67
9 - Suffering......Page 71
10 - Culture, Ethnicity, and Illness......Page 76
11 - The Desire for Death......Page 80
12 - Spiritual Distress......Page 84
13 - Families in Distress......Page 88
14 - Grief and Bereavement......Page 94
15 - Stress and Burnout......Page 100
16 - Body Image and Sexuality......Page 108
17 - Principles of Bioethics......Page 113
18 - Ethics and Clinical Practice......Page 119
19 - Advanced Directives......Page 123
20 - Withholding and Withdrawing Treatment......Page 129
21 - Euthanasia and Physician-Assisted Suicide......Page 135
22 - Research Bioethics......Page 140
23 - Curriculum Development......Page 144
24 - Adult Learning......Page 150
25 - Web-Based Learning......Page 156
26 - Principles of Palliative Medicine Research......Page 161
27 - Developing a Research Group......Page 169
28 - Design and Conduct of Research and Clinical Trials......Page 173
29 - Biostatistics and Epidemiology......Page 181
30 - Symptom Research......Page 186
31 - Health Services Research......Page 190
32 - Psychosocial Research......Page 195
33 - Qualitative Methodology......Page 200
34 - Priorities for the Future: The Research Agenda......Page 206
35 - Program Development: An International Perspective......Page 214
36 - Program Development: National Planning......Page 217
37 - Program Development: Palliative Medicine and Public Health Services......Page 223
38 - Consultation Services......Page 228
39 - Acute Palliative Medicine Units......Page 233
40 - Inpatient Hospice and Palliative Care Units......Page 237
41 - Palliative Medicine in Institutions......Page 241
42 - Home Care and Hospice Home Care......Page 244
43 - The Business of Palliative Medicine: Quality Care in a Challenging Environment......Page 250
44 - Development of National and International Standards......Page 255
45 - Clinical Practice Guidelines......Page 264
46 - Evidence-Based Economic Evaluation......Page 270
47 - The Interdisciplinary Team......Page 278
48 - The Physician......Page 284
49 - Nurses and Nurse Practitioners......Page 290
50 - The Social Worker......Page 294
51 - The Nutrition Support Team......Page 298
52 - Occupational and Physical Therapy......Page 302
53 - The Speech-Language Pathologist......Page 304
54 - Psychiatrists and Clinical Psychologists......Page 307
55 - Spiritual Care......Page 314
56 - The Role of the Clinical Pharmacist......Page 318
57 - Palliative Medicine and the Ethics Consultant......Page 322
58 - Music and Art Therapists......Page 324
59 - Wound and Stoma Therapists......Page 328
60 - The Volunteer......Page 330
61 - History and Physical Examination......Page 333
62 - Assessing the Family and Caregivers......Page 343
63 - Clinical Symptom Assessment......Page 348
64 - Qualitative and Quantitative Symptom Assessment......Page 356
65 - Measuring Quality of Life......Page 364
66 - The Neuropsychological Examination......Page 375
67 - Sexuality and Intimacy in the Critically Ill......Page 378
68 - Assessment of Mobility......Page 382
69 - Nuclear Medicine......Page 387
70 - Computed Tomography Scanning and Magnetic Resonance Imaging in Palliative Care......Page 390
71 - Positron Emission Tomography......Page 394
72 - Cardiac Function Testing......Page 401
73 - Pulmonary Function......Page 408
74 - Laboratory Hematology......Page 413
75 - The Role of Pathology......Page 427
76 - Common Medical and Surgical Disorders......Page 432
77 - Common Musculoskeletal Co-morbidities......Page 436
78 - Diabetes Mellitus......Page 440
79 - Heart Failure......Page 449
80 - Arrhythmias......Page 454
81 - Hypertension......Page 458
82 - Kidney Failure......Page 466
83 - Alcohol and Drug Abuse......Page 474
84 - Liver Failure......Page 482
85 - Deep Vein Thrombosis......Page 488
86 - Persistent or Repeated Hemorrhage......Page 493
87 - Lymphedema......Page 497
88 - Pressure Ulcers and Wound Care......Page 501
89 - Stomas and Fistulas......Page 507
90 - Emergencies in Palliative Medicine......Page 515
91 - Infections In Palliative Medicine......Page 528
92 - Prevention and Control of Infections......Page 532
93 - Urinary Tract Infections......Page 539
94 - Health Care–Acquired Infections......Page 542
95 - Fatal and Fulminant Infections......Page 550
96 - Antimicrobial Use in the Dying......Page 555
97 - Palliative Surgery......Page 558
98 - Gastrointestinal Endoscopy......Page 564
99 - Palliative Management of Airway Obstruction: Tracheostomy and Airway Stents......Page 567
100 - Pleural and Peritoneal Catheters......Page 573
101 - Interventional Radiology......Page 578
102 - Durable Medical Equipment......Page 588
103 - Communication Devices......Page 596
104 - Physiology of Nutrition and Aging......Page 600
105 - Determination of Nutrition and Hydration......Page 605
106 - The Anorexia-Cachexia Syndrome......Page 610
107 - Clinical Nutrition......Page 618
108 - Principles and Management of Nutritional Support in Cancer......Page 625
109 - Nutrition in Palliative Medicine......Page 630
110 - Good Communication: Patients, Families, and Professionals......Page 635
111 - Telling the Truth: Bad News......Page 642
112 - Problems in Communication......Page 647
113 - Counseling......Page 652
114 - Public Advocacy and Community Outreach......Page 656
115 - Telemedicine......Page 659
116 - Making Good Decisions......Page 665
117 - Denial and Decision-Making Capacity......Page 669
118 - Evidence-Based Decision Making: Challenges and Opportunities......Page 673
119 - Determining Prognosis......Page 679
120 - The Plan of Care......Page 684
121 - Principles of Pharmacology......Page 689
122 - Neuropharmacology and Psychopharmacology......Page 696
123 - Prescribing......Page 708
124 - Interactions, Side Effects, and Management......Page 713
125 - Drug Use in Special Populations......Page 717
126 - Kidney and Liver Disease......Page 721
127 - Routes of Administration......Page 727
128 - Development and Use of a Formulary......Page 732
129 - Antacids......Page 736
130 - Antidepressants and Psychostimulants......Page 740
131 - Antibiotics......Page 744
132 - Antiepileptic Drugs......Page 747
133 - Cancer-Related Weight Loss......Page 753
134 - Anxiolytics, Sedatives, and Hypnotics......Page 757
135 - Nonsteroidal Anti-inflammatory Drugs......Page 761
136 - Diuretics......Page 766
137 - Bronchodilators and Cough Suppressants......Page 770
138 - Opioids......Page 775
139 - Psychotropic Drugs......Page 780
140 - Laxatives......Page 788
141 - Cardiac Drugs......Page 792
142 - Local and General Anesthetics......Page 798
143 - Drugs for Hypercalcemia......Page 802
144 - Antiemetic Drugs......Page 806
145 - Corticosteroids......Page 818
146 - Drugs for Myoclonus and Tremors......Page 822
147 - Drugs for Diarrhea......Page 827
148 - Principles of Symptom Control......Page 834
149 - Symptom Epidemiology and Clusters......Page 842
150 - Anorexia and Weight Loss......Page 847
151 - Anxiety......Page 854
152 - Syncope and Blackouts......Page 858
153 - Airway Obstruction......Page 863
154 - Constipation and Diarrhea......Page 867
155 - Cough, Hemoptysis, and Bronchorrhea......Page 875
156 - Delirium and Psychosis......Page 881
157 - Depression......Page 886
158 - Dysphagia......Page 892
159 - Dyspnea......Page 898
160 - Edema......Page 902
161 - Fatigue......Page 907
162 - Fever and Sweats......Page 911
163 - Hiccups......Page 915
164 - Incontinence: Urine and Stool......Page 919
165 - Indigestion......Page 926
166 - Pruritus......Page 931
167 - Memory Problems......Page 934
168 - Muscle Spasms......Page 937
169 - Nausea, Vomiting, and Early Satiety......Page 942
170 - Nonmalignant Pain......Page 952
171 - Oral Symptoms......Page 958
172 - Tenesmus, Strangury, and Malodor......Page 967
173 - Premature Menopause......Page 971
174 - Death Rattle......Page 977
175 - Seizures and Movement Disorders......Page 982
176 - Sleep Problems and Nightmares......Page 986
177 - Diagnosis of Death and Dying......Page 994
178 - Standards of Care......Page 999
179 - Palliative Sedation......Page 1004
180 - Care of the Dying: Hospitals and Intensive Care Units......Page 1009
181 - Comfort Care: Symptom Control in the Dying......Page 1018
182 - Integrative Medicine: Complementary Therapies......Page 1022
183 - Organ Transplantation......Page 1028
184 - Cardiovascular Disorders......Page 1032
185 - Respiratory Failure......Page 1036
186 - Respiratory Equipment......Page 1041
187 - Congenital Intellectual Disability......Page 1047
188 - Musculoskeletal Disorders......Page 1053
189 - Stroke......Page 1060
190 - Parkinson's Disease......Page 1064
191 - Multiple Sclerosis......Page 1074
192 - Amyotrophic Lateral Sclerosis......Page 1082
193 - Quadriplegia and Paraplegia......Page 1087
194 - Neonates, Children, and Adolescents......Page 1091
195 - Cancer in Children......Page 1099
196 - Psychological Adaptation of the Dying Child......Page 1105
197 - Family Adjustment and Support......Page 1113
198 - Pediatric Pain and Symptom Control......Page 1117
199 - Hospice and Special Services......Page 1125
200 - Pediatric Palliative Care: Interdisciplinary Support......Page 1130
201 - Parent and Child Bereavement......Page 1135
202 - Demographics of Aging......Page 1140
203 - Biology and Physiology of Aging......Page 1143
204 - The Aging Brain and Dementia......Page 1150
205 - The Frail Elderly......Page 1152
206 - Caregiver Burden......Page 1160
207 - Community Services......Page 1163
208 - Acquired Immunodeficiency Syndrome: A Global Perspective......Page 1167
209 - Biology and Natural History of Acquired Immunodeficiency Syndrome......Page 1171
210 - Acquired Immunodeficiency Syndrome in Adults......Page 1177
211 - Palliative Care for Children and Adolescents with Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome......Page 1183
212 - Complications of Acquired Immunodeficiency Syndrome......Page 1192
213 - Treatment of Persons Infected with the Human Immunodeficiency Virus......Page 1203
214 - Symptom Management......Page 1211
215 - Biology of Cancer......Page 1222
216 - Epidemiology of Cancer......Page 1225
217 - Natural History of Cancer......Page 1232
218 - Principles of Medical Oncology......Page 1241
219 - Patterns of Metastatic Cancer......Page 1249
220 - Neurological Complications......Page 1255
221 - Brain Metastases......Page 1258
222 - Bone Metastases......Page 1262
223 - Vertebral Metastases and Spinal Cord Compression......Page 1265
224 - Malignant Ascites......Page 1278
225 - Pleural and Pericardial Effusions......Page 1281
226 - Intestinal Dysfunction and Obstruction......Page 1285
227 - Genitourinary Complications in Palliative Oncology......Page 1294
228 - Hypercalcemia......Page 1300
229 - Bone Marrow Failure......Page 1304
230 - Bleeding and Clotting Disorders in Cancer......Page 1311
231 - The Vena Cava Syndrome......Page 1323
232 - Oral Complications of Cancer and Its Treatment......Page 1325
233 - Paraneoplastic Syndromes......Page 1329
234 - Autonomic Dysfunction......Page 1337
235 - Radiation Principles and Techniques......Page 1342
236 - Complications of Radiation Therapy......Page 1345
237 - Palliative Radiation Therapy......Page 1355
238 - Principles of Modern Chemotherapy and Endocrine Therapy......Page 1363
239 - Complications of Chemotherapy......Page 1371
240 - Palliative Chemotherapy and Corticosteroids......Page 1378
241 - Principles and Practice of Surgical Oncology......Page 1381
242 - Palliative Orthopedic Surgery......Page 1385
243 - Modern Supportive Care in Oncology......Page 1391
244 - Pathophysiology of Cancer Pain......Page 1396
245 - Psychological and Psychiatric Approaches......Page 1402
246 - Rehabilitation Approaches......Page 1407
247 - Cancer Pain: Anesthetic and Neurosurgical Interventions......Page 1412
248 - Acupuncture, Transcutaneous Electrical Nerve Stimulation, and Topical Analgesics......Page 1416
249 - Opioids for Cancer Pain......Page 1422
250 - Opioid Side Effects and Overdose......Page 1429
251 - Opioid Use in Drug and Alcohol Abuse......Page 1434
252 - Nonopioid and Adjuvant Analgesics......Page 1439
253 - Challenging Pain Problems......Page 1443
254 - Pain in Cancer Survivors......Page 1448
Index
......Page 1454