What are the recommended approaches for managing common symptoms such as nausea and breathlessness in palliative care?

For managing nausea in palliative care: Assess for likely causes such as medications, recent chemotherapy, biochemical causes, or gastrointestinal motility disorders, and discuss treatment options with the patient and their carers ¹.

Consider non-pharmacological methods for treating nausea and vomiting in the last days of life ¹.

When choosing medicines, consider the likely cause, side effects, other symptoms, drug interactions, and patient preferences ¹.

Use the most appropriate route of administration, such as subcutaneous or intravenous injections if oral intake is not tolerated ¹.

Start with the lowest effective dose and titrate as needed, with regular reassessment of symptoms ¹.

For managing breathlessness in palliative care: Identify and treat reversible causes such as pulmonary oedema or pleural effusion ¹.

Consider non-pharmacological management, including breathing control and psychosocial support, delivered by a multidisciplinary team ¹.

Do not routinely start oxygen therapy; only offer it to those with symptomatic hypoxaemia ¹.

Manage breathlessness with opioids, benzodiazepines, or a combination of both, considering off-label use in this context ¹.