Abstract
This article describes our experience in the clinical use of nebulized opioids for the management of dyspnoea in patients with terminal cancer by reviewing three specific patient case studies in which this treatment was found to be both safe and effective in controlling breathlessness. The patients were treated with morphine, hydromorphone or anileridine in various doses according to their prior use of opioids. Additional formal studies are being initiated at this Centre.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Belvisi MG, Chung KF, Jackson DM, Barnes PJ (1988) Opioid modulation of noncholinergic neural bronchoconstriction in guinea pig in vivo. Br J Pharmacol 95:413–418
Bruera E, Macmillan K, Pither J, MacDonald N (1990) Effects of morphine on the dyspnea of terminal cancer patients. J Pain Symptom Manage 5:341–344
Chrubasik J, Wust H, Friedrich G, Geller E (1988) Absorption and bioavailability of nebulized morphine. Br J Anaesth 61:228–230
Conno F de, Spoldi E, Caraceni A, Ventafridda V (1991) Does pharmacological treatment affect the sensation of breathlessness in terminal cancer patients? Palliat Med 5:237–243
Cowcher K, Hanks G (1990) Long-term management of respiratory symptoms in advanced cancer. J Pain Symptom Manage 5:320–330
Farncombe M, Chater S (1993) Case studies outlining use of nebulized morphine in patients with end-stage chronic lung and cardiac disease. J Pain Symptom Manage 8: 221–225
Hughes S, Calverley PMA (1988) Heroin inhalation and asthma. Br Med J 297:1511–1512
Johansson IGM, Grundstom N, Anersson RRG (1988) Modulation of the airways excitatory neuronal pathways via alpha 2 adrenoceptors and opioid receptors. Acta Physiol Scand 134 [Suppl 575]:29
Johnson MA, Woodcock AA, Geddes DM (1983) Dihydrocodeine for breathlessness in ‘pink puffers’. Br Med J 286:675–677
Light R, Muro J, Sato R, Stansbury DW, Fischer CE, Brown SE (1989) Effects of oral morphine on breathlessness and exercise tolerance in patients with chronic obstructive pulmonary disease. Am Rev Respir Dis 139:126–133
Masters N, Heap G, Wedly J, Moore A (1988) Inhaled nebulized morphine and diamorphine: useful in general practise? Practitioner 232:910–914
Regnard C, Ahmedzai S (1990) Dyspnea in advanced cancer — a flow diagram. Palliat Med 4:311–315
Reuben D, Mor V (1986) Dyspnea in terminally ill cancer patients. Chest 89:234–236
Roger DF, Barnes PG (1989) Opioid inhibition of neurally medicated mucous secretion in human bronchi. Lancet I:930–931
Weill JV, McCullough RE, Kline JS, Sodal IE (1975) Diminished ventilatory response to hypoxia and hypercapnia after morphine in normal man. N Engl J Med 292:1103–1106
Woodcock AA, Gross ER, Gellert A, Shah S, Johnson M, Geddes D (1981) Effects of dihydrocodeine, alcohol and caffeine on obstructive lung disease and normal blood gases. N Engl J Med 305:1611–1616
Young H, Daviskas E, Keena VA (1989) Effects of low dose nebulized morphine on exercise endurance in patients with chronic lung disease. Thorax 4:387–390
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Farncombe, M., Chater, S. Clinical application of nebulized opioids for treatment of dyspnoea in patients with malignant disease. Support Care Cancer 2, 184–187 (1994). https://doi.org/10.1007/BF00417478
Issue Date:
DOI: https://doi.org/10.1007/BF00417478