Common Causes of Agitation in Palliative Care and Their Management
| Identify and treat underlying cause | |
|---|---|
Infection Urinary retention | Adverse effect of drugs (e.g. opioid toxicity) Brain or meningeal metastases Electrolyte disorder (e.g. hyponatraemia, hypercalcaemia) Paraneoplastic effect |
| Non-pharmacological measures | |
Reassure patient and their family Move to quiet side-room Nurse in a moderately-lit room | |
Pharmacological therapy Only if absolutely necessary; choose doses according to age and physical condition Haloperidol 1.5–3 mg (0.5–1 mg elderly) once daily at night or 12-hourly (oral or SC) Benzodiazepine, for example lorazepam 0.5–1 mg sublingual as needed sublingual up to 12-hourly or midazolam 2.5–5 mg SC 12-hourly. | |