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Medications in Dying Phase — SCE Medical Oncology MCQ

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EasySupportive & Palliative OncologyMedications in Dying PhaseSCE Medical Oncology

A 72-year-old man with terminal cancer becomes unconscious and appears to be in his last hours of life. His family asks whether he should continue receiving his regular medications via the syringe driver. What medications should be continued in the dying phase?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Only medications needed for symptom control in the dying phase should be continued (analgesics, anti-emetics, anxiolytics, antisecretory agents) — all non-essential medications (antihypertensives, statins, diabetes medications, antibiotics without comfort benefit, bisphosphonates) should be discontinued

NICE NG31 (Care of dying adults) recommends that when a patient is recognised as dying: (1) CONTINUE: symptom-control medications (opioids for pain, midazolam for agitation, haloperidol for nausea/delirium, hyoscine/glycopyrronium for secretions — via syringe driver), (2) DISCONTINUE: medications providing no immediate comfort benefit (antihypertensives, statins, anticoagulants, diabetes medications, bisphosphonates, vitamins, prophylactic antibiotics). This medication review reduces pill burden and unnecessary interventions while maintaining comfort.

Reference: NICE NG31 Care of dying adults; ESMO Palliative Care; GMC End-of-life guidance