The Clinical Guide to Supportive and Palliative Care for HIV/AIDS

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A Clinical Guide to Supportive and Palliative Care for HIV/AIDS • Chapter 2: Overview of Clinical IssuesTable 2-4: Common Symptoms in Patients with AIDS and Possible Disease-Specific and Palliative Interventions26 picasPossible Causes Disease-Specific Rx Palliative RxCorticosteroids (prednisone, dexamethasone)Psychostimulants (methylphenidine, pemoline,dextroamphetamine, modafinil)HAARTTreat specific infectionsErythropoeitin, transfusionAIDSOpportunistic InfectionsAnemiaFatigue, weaknessConstitutionalCorticosteroidsTestosterone/ androgensOxandroloneMegestrol acetateDronabinolRecombinant growth hormoneHAARTChemotherapyNutritional support/Enteral feedingsHIVMalignancyWeight loss,anorexiaNSAIDS (ibuprofen, indomethicin, cox-2 inhibitors)CorticosteroidsAnti-cholinergics (hyoscine, thioridazine)H2-antagonists (cimetidine)Azithromycin, ethambutolGanciclovir, foscarnetHAARTChemotherapyMACCMVHIVLymphomaFevers, sweatsNSAIDSOpioidsCorticosteroidsTreat specific diseaseentitiesOpportunistic infections,HIV-related malignancies,non-specificNociceptive-Somatic-VisceralPainNSAIDSOpioids (esp. methadone)and adjuvants- trycyclic anti-depressants (amitriptyline,imipramine)- benzodiazepines (clonazepam)- anti-convulsants (gabapentin, carbamazepine)CorticosteroidsAcupunctureHAARTGanciclovir, foscarnetAcyclovir, famciclovirHIV-related peripheral neuropathyCMVVZVNeuropathicChange antiretroviral orother regimendideoxynucleosides(didanosine, zalcitabine,stavudine)other medications (isoniazid)20U.S. Department of Health and Human Services • Health Resources and Services Administration • HIV/AIDS Bureau
A Clinical Guide to Supportive and Palliative Care for HIV/AIDS • Chapter 2: Overview of Clinical IssuesTable 2-4: Common Symptoms in Patients with AIDS and Possible Disease-Specific and Palliative Interventions (continued)Possible Causes Disease-Specific Rx Palliative RxDopamine antagonists (haloperidol, prochloperazine)Prokinetic agents (metaclopromide)Antihistamines (diphenhydramine, promethazine)Anticholinergics (hyoscine, scopalamine)26 picasFluconazole, amphotericin-BGanciclovir, foscarnetChange antiretroviral regimenEsophageal candidiasisCMVHAARTNausea/ VomitingGastrointestinalSerotonin antagonists (granisetron, ondansetron,dolasetron)H2-antagonists (cimetidine)Proton pump inhibitors (omeprazole)Somatostatin analogues (octreotide)Benzodiazepines (lorazepam)CorticosteroidsBismuth, methylcellulose, kaolinDiphenoxylate + atropineLoperamideOctreotideTincture of opium (paregoric)Azithromycin, ethambutolParomomycinGanciclovir, foscarnetAlbendazoleOther anti-parasitic agentsOther antibioticsMACCryptosporidiosisCMVMicrosporidiosisOther intestinal parasitesBacterial gastroenteritisMalabsorptionDiarrheaActivity/dietProphylaxis on opioidsSoftening agents- surfactant laxatives (docusate)- bulk-forming agents (bran, methylcellulose)- osmotic laxatives (lactulose, sorbitol)- saline laxatives (magnesium hydroxide)Peristalsis-stimulating agents- anthracenes (senna)- polyphenolics (bisacodyl)HydrationRadiation/chemotherapyMedication adjustmentDehydrationMalignancyAnticholinergics, opioidsConstipationIIU.S. Department of Health and Human Services • Health Resources and Services Administration • HIV/AIDS Bureau 21
Page 4 and 5: DedicationA Clinical Guide to Suppo
Page 6 and 7: Lynn A Jansen, RN, PhDAssistant Res
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Chapter 14.26 picasCulture and Care
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Chapter 17.26 picasEthical IssuesLy
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DRUGS AND THERAPIES INDEXNOTES: Ent
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The Clinical Guide to Supportive and Palliative Care for HIV/AIDS

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