[Medical Information] Physical Symptoms and Their Management_2

[Medical Information] Physical Symptoms and Their Management_2

 

Constipation: Previous treatments before medications are physical activity, adequate hydration, and dietary treatments with fiber. But fiber can be problems, e.g., under opioid use. Common medications are as follows: stimulant and osmotic laxatives, stool softeners, fluids, and enemas. To prevent constipation in presence of opioid, laxative and a stool softener (such as senna and docusate) should be used. If several trials of medications are not helpful, a rectal examination to rule out impaction is necessary.

 

Nausea: Nausea and vomiting are caused by stimulation at these sites: GI tract, the vestibular system, the chemoreceptor trigger zone, and the cerebral cortex. So, medications for nausea act these sites. The reasons of nausea are as follows: liver failure, uremia, hypercalcemia, bowel obstruction, constipation, infection, GERD, vestibular disease, brain metastasis, antibiotics, opioids, and radiation therapy. Also, anxiety. If a patient appeals unspecific sign, initial treatments can be metoclopramide, 5-HT3 receptor antagonist (e.g., ondansetron), dopamine antagonist (e,g., chloropromazine). In specific cases, metoclopramide is used in decreased motility, steroid in inflammation, 5-HT3 antagonist in chemotherapy and radiation therapy, antihistamine in a vesttibular disease, and benzodiazepine in anticipatory nausea.

 

Dyspnea: Dyspnea is the subjective experience of being short of breath. If a patient has a history of COPD or asthma, inhaled bronchodilators and glucocorticoids may be helpful. If a patient has a pulmonary edema, diuretics may be helpful. Low-dose opioids can reduce experience of dyspnea in other patients. Besides, sitting upright, fresh air with sufficient humidity can be helpful.

 

Fatigue: The reasons of fatigue are as follows: dehydration, anemia, infection, hypothyroidism, liver dysfunction, and cancer. Fatigue is also the subjective experience of tiredness or decreased activity. Understanding that fatigue is physiologic and not psychologic can help a patient's will.