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 Interventions (continued)26 picasPossible Causes Disease-Specific Rx Palliative RxUse of fan, open windows, oxygenOpioidsBronchodilatorsMethylxanthinesBenzodiazepines (lorazepam)Trimethoprim/sulfamethoxazole,pentamidine, atovaquone etc.Other antibioticsErythropoetin, tranfusionDrainage/radiation/surgeryPCPDyspneaRespiratoryBacterial pneumoniaAnemiaPleural effusion/mass/obstructionDecreased respiratory musclefunctionCough suppressants (dextromethorphan, codeine,other opioids)Decongestants, expectorants (various)Anti-infective therapy(as above)Antituberculous chemotherapyPCP, bacterial pneumoniaCoughTBAnticholinergics (atropine, hyoscine, scopalomine,glycopyrrolate)Fluid restrictionDiscontinue intravenous fluidsAntibiotics as indicatedFluid shifts, ineffective cough,sepsis, pneumoniaIncreased secretions(‘death rattle’)Emollients +/- salicylatesLubricating ointmentsHydrationDialysisDehydrationEnd-stage renal diseaseEnd-stage liver diseaseMalnutritionDry skinDermatologicNutritional support22U.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 RxTopical agents (menthol, phenol, calamine, doxepin,capsaicin)Antihistamines (diphenhydramine)Corticosteroids26 picasAntifungalsDialysisFungal infectionEnd-stage renal diseaseEnd-stage liver diseaseDehydrationEosinophilic follicultitisPruritisDermatologic(continuted)Serotonin antagonists (ondansetron)Opioid antagonists (naloxone, naltrexone)Anti-depressantsAnxiolyticsNeurolepticsThalidomide (?)HydrationSteroids, antifungalsPrevention (nutrition, mobility, skin integrity)Wound protection (semi-permeablefilm/hydrocolloid dressing)Debridement (normal saline, enzymatic agents,alginates)NutritionIncrease mobilityPoor nutritionDecreased mobilityProlonged bed restDecubiti/PressureSoresNeuroleptics (haloperidol, risperidone,chlorpromazine)Benzodiazepines (lorazepam, midazolam)Correct imbalancesHydrationSulfadiazine/pyrimethamine, etc.AntifungalsAntibioticsElectrolyte imbalancesDehydrationToxoplasmosisCryptococcal meningitisSepsisDelirium/AgitationNeuropsychiatricPsychostimulants (methylphenidate)Low dose neuroleptics (haloperidol)HAARTAIDS - related dementiaDementiaPsychostimulants (methylphenidate, pemoline,dextroamphetamine, modafinil)Corticosteroids (prednisone, dexamethasone)Antidepressants(tricyclics, SSRIs,MAO inhibitors, other)Chronic illnessReactive depressionMajor depressionDepressionIIU.S. Department of Health and Human Services • Health Resources and Services Administration • HIV/AIDS Bureau 23
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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The Clinical Guide to Supportive and Palliative Care for HIV/AIDS

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