Asked and Answered


    Medications

    As an illness progresses and end of life is near, is it reasonable to discontinue medications?
    The health care team, the patient and the family together need to consider several factors before making any change in medications. All these questions need to be answered: What are the patient’s or family’s goals for care? This may be the most important question. The goals must be realistic and achievable. For example, it may not be realistic... read more...
    Does morphine make death come sooner?
    Concerns are commonly raised about whether opioids speed up the dying process, and this question has been extensively studied. There is no evidence that morphine or other opioids accelerate the dying process when used in dosages needed to control pain or dyspnea . In fact, there is evidence of the opposite effect. Palliative care providers... read more...
    Is there something other than Tylenol® that can be given for bone pain due to cancer?
    There are several options that can be considered for pain relief with bone pain. Tylenol® is the brand name of acetaminophen . It’s a good painkiller for bone pain, but it may not be strong enough to relieve completely the pain of cancer in the bones. The maximum dose of acetaminophen is 4, 000 mg a day. It’s very important to check with the... read more...
    My mother had regular pain medication at home, and it was working. When she was admitted to hospital, the pain medication was given “as needed.” Why was this changed?
    If your mother was receiving regular pain medication at home, the same dosage needs to continue in hospital. It’s rare that a pain medication regimen is stopped altogether and given just "as needed" (what health care providers call “prn”). One of two different things may be happening. Your mother may in fact be getting medications just as... read more...
    What are the side effects of dexamethasone?
    Dexamethasone (Decadron®) is one of a group of medications called corticosteroids. This group of medications has a set of side effects that together are known as Cushing’s syndrome. The common side effects include weight gain, increased appetite, bloating, filling of the face (called moon face) and filling of the abdominal area. These side... read more...
    What are the side effects of morphine? Does morphine change someone’s physical appearance?
    Morphine and other opioid medications generally have these side effects: Sleepiness Some level of sleepiness or drowsiness is common when the medication is first started or the dosage increased. It usually lasts about two to three days.   Fatigue     Nausea This may occur with the drowsiness. It too tends to subside after a few days, as the... read more...
    What can be done with medications that are left over after someone dies, or with medications that aren’t being used any more?
    It’s not a good idea to flush leftover medications down the toilet, as this pollutes the environment. It’s not a good idea either to keep medications at home, as this can be a safety issue. It is a good idea to take leftover medications to a pharmacy, so someone there can dispose of the medications properly. Most pharmacies take leftover medications... read more...
    What happens if someone has a morphine overdose? Is there a certain amount of morphine that can cause an overdose?
    The amount of morphine that can cause an overdose or death depends on what a person’s body is used to. It takes more morphine to cause an overdose in someone who is already taking morphine than in someone who has never had it before. Morphine and other opioids are given to control pain . When taking morphine for pain, the body may develop... read more...
    What is hydromorphone? Why might someone be switched from morphine to hydromorphone?
    Hydromorphone (Dilaudid®) is a painkiller in the opioid family, as is morphine. Hydromorphone is chemically related to morphine, and very commonly used for moderate to severe pain . Often people are switched from morphine to hydromorphone to treat possible side effects from ongoing use of morphine, such as confusion or uncontrolled jerking... read more...
    What’s the difference between hydromorphone, morphine, Dilaudid® and fentanyl patches? When would each of these be used?
    All these medications are opioids. This is a group of medications that target certain receptors in the body in order to relieve pain . When treating pain with opioids it’s typical to start with a low dosage, monitor to see how it’s working, and gradually increase the dosage until the person is comfortable. The monitoring is needed to check... read more...
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