ASCO GUIDELINES Bundle

Dyspnea in Advanced Cancer

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5 5. Pharmacologic Interventions ➤ Systemic opioids should be offered to patients with dyspnea when non-pharmacologic interventions are insufficient to provide dyspnea relief. (Moderate recommendation; EB-L) ➤ Short-acting benzodiazepines may be offered to patients who experience dyspnea-related anxiety and continue to experience dyspnea despite opioids and other non-pharmacologic measures. (Weak recommendation; EB-L) ➤ Systemic corticosteroids may be offered to select patients with airway obstruction or when inflammation is likely a key contributor to dyspnea. (Weak recommendation; EB-L) ➤ Bronchodilators should be used for palliation of dyspnea when patients have established obstructive pulmonary disorders or evidence of bronchospasm. (Weak recommendation; EB-L) ➤ Evidence remains insufficient for a recommendation for or against the use of anti-depressants, neuroleptics, or inhaled furosemide for dyspnea. ➤ Continuous palliative sedation should be offered to patients with dyspnea that is refractory to all standard treatment options and all applicable palliative options, and who have an expected life expectancy of days. (Moderate recommendation; IC-L)

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