Palliative care 2017

Safety of benzodiazepines and opioids in very severe respiratory disease: national prospective study

BMJ 2014;348:g445 M Ekström, Department of Medicine, Blekinge Hospital, SE-37185, Karlskrona, Sweden pmekstrom@gmail.com

The approach for chronic refractory breathlessness is not different from that of opioid treatment for refractory pain .

Sustained release morphine should be a first line treatment and should be initiated at a low dose and titrated upward over days and weeks, balancing beneficial and adverse effects. Titration up to 30 mg morphine/d might safely improve breathlessness in > 60% of patients, with a mean decrease of 35% in the intensity of breathlessness from the person’s own baseline.