Examples of medications to consider for travel comfort care
| Indication | Medications | Considerations |
|---|---|---|
| Long-acting pain control | Fentanyl patch Methadone Morphine extended-release | Current and predicted pain Prior pain medication use, familiarity, and tolerance Future ability to take oral medications |
| Breakthrough pain or dyspnea | Morphine sulfate oral solution | Can be used when patient loses ability to purposefully swallow |
| Terminal fever or pain | Acetaminophen | Pills can be used orally or rectally Low risk of diversion |
| Nausea and vomiting | Ondansetron Promethazine | Consider if single medications can be used for multiple symptoms |
| Pain, nausea, cancer-related swelling, or obstruction | Dexamethasone | Multimodal effect Benefits usually maximized over 2 weeks Use cautiously if hyperglycemia is a concern |
| Terminal agitation, anxiety, seizures, and nausea | Lorazepam Olanzapine Haloperidol | Useful for spectrum of symptoms in terminal phase |
| Constipation | Bisacodyl Polyethylene glycol | Bisacodyl oral pill can be used rectally when patient loses ability to swallow |
| Secretions, death rattle | Atropine 1% drops | Coach family on repositioning |