Off-label Medication Use of Asenapine Sublingual Tablets for Agitated Delirium in Cancer Patients at the End of Life
Delirium occurs in 30-40% of patients with terminal cancer, and 90% of patients are delirious immediately before death. Symptoms such as agitation and hallucination are often refractory to the standard pharmacological therapy. Also, the medication options for delirium in terminally ill patients are...
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Veröffentlicht in: | Palliative Care Research 2021, Vol.16(3), pp.261-265 |
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creator | Nakano, Hiroki Akashi, Naoko Wada, Tomomi Ide, Kyoko Inoue, Atsuyuki Miyabe, Takashi Yamauchi, Kazutaka |
description | Delirium occurs in 30-40% of patients with terminal cancer, and 90% of patients are delirious immediately before death. Symptoms such as agitation and hallucination are often refractory to the standard pharmacological therapy. Also, the medication options for delirium in terminally ill patients are often limited due to a difficulty in swallowing or a lack of intravenous access. We herein report a case series of six patients with terminal cancer whose derilium symptoms were treated by asenapine sublingual tablets during the intervention period by the palliative care team. Asenapine was selected when other antipsychotics were ineffective or unavailable for agitation caused by delirium. All patients suffered dyspnea or choking sensations due to dysphagia or respiratory dysfunction. Sedative effect was observed among all patients without apparent adverse events. Sublingual asenapine could be an option for the management of restlessness due to terminal delirium when both oral and intravenous drug administration routes are not available. |
doi_str_mv | 10.2512/jspm.16.261 |
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Symptoms such as agitation and hallucination are often refractory to the standard pharmacological therapy. Also, the medication options for delirium in terminally ill patients are often limited due to a difficulty in swallowing or a lack of intravenous access. We herein report a case series of six patients with terminal cancer whose derilium symptoms were treated by asenapine sublingual tablets during the intervention period by the palliative care team. Asenapine was selected when other antipsychotics were ineffective or unavailable for agitation caused by delirium. All patients suffered dyspnea or choking sensations due to dysphagia or respiratory dysfunction. Sedative effect was observed among all patients without apparent adverse events. Sublingual asenapine could be an option for the management of restlessness due to terminal delirium when both oral and intravenous drug administration routes are not available.</description><identifier>ISSN: 1880-5302</identifier><identifier>EISSN: 1880-5302</identifier><identifier>DOI: 10.2512/jspm.16.261</identifier><language>eng ; jpn</language><publisher>Japanese Society for Palliative Medicine</publisher><subject>asenapine ; delirium ; terminal cancer patients</subject><ispartof>Palliative Care Research, 2021, Vol.16(3), pp.261-265</ispartof><rights>2021 by Japanese Society for Palliative Medicine</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c1281-2ed21096eba167ab4f1f99a69e5a3e33c347aba0d332a3f084d74af8fe03b1843</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,1877,4010,27902,27903,27904</link.rule.ids></links><search><creatorcontrib>Nakano, Hiroki</creatorcontrib><creatorcontrib>Akashi, Naoko</creatorcontrib><creatorcontrib>Wada, Tomomi</creatorcontrib><creatorcontrib>Ide, Kyoko</creatorcontrib><creatorcontrib>Inoue, Atsuyuki</creatorcontrib><creatorcontrib>Miyabe, Takashi</creatorcontrib><creatorcontrib>Yamauchi, Kazutaka</creatorcontrib><title>Off-label Medication Use of Asenapine Sublingual Tablets for Agitated Delirium in Cancer Patients at the End of Life</title><title>Palliative Care Research</title><addtitle>Palliat Care Res</addtitle><description>Delirium occurs in 30-40% of patients with terminal cancer, and 90% of patients are delirious immediately before death. Symptoms such as agitation and hallucination are often refractory to the standard pharmacological therapy. Also, the medication options for delirium in terminally ill patients are often limited due to a difficulty in swallowing or a lack of intravenous access. We herein report a case series of six patients with terminal cancer whose derilium symptoms were treated by asenapine sublingual tablets during the intervention period by the palliative care team. Asenapine was selected when other antipsychotics were ineffective or unavailable for agitation caused by delirium. All patients suffered dyspnea or choking sensations due to dysphagia or respiratory dysfunction. Sedative effect was observed among all patients without apparent adverse events. Sublingual asenapine could be an option for the management of restlessness due to terminal delirium when both oral and intravenous drug administration routes are not available.</description><subject>asenapine</subject><subject>delirium</subject><subject>terminal cancer patients</subject><issn>1880-5302</issn><issn>1880-5302</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNpNkE1rAjEQhkNpoWI99Q_kXtbmy3X3UhBrP8BioXpeJrsTjcSsJNlD_31XFOlphnmfeQ4vIY-cjcWEi-d9PB7GPB-LnN-QAS8Klk0kE7f_9nsyitFqxoQqlFJiQNLKmMyBRke_sLE1JNt6uolIW0NnET0crUf602ln_bYDR9egHaZITRvobGsTJGzoKzobbHeg1tM5-BoD_e5V6HsQEk07pAvfnJxLa_CB3BlwEUeXOSSbt8V6_pEtV--f89kyq7koeCawEZyVOWrg-RS0MtyUJeQlTkCilLVU_RVYI6UAaVihmqkCUxhkUvNCySF5Onvr0MYY0FTHYA8QfivOqlNn1amziudV31lPv5zpfUywxSsLIdna4ZWVl4drUO8gVOjlH3Mddvg</recordid><startdate>2021</startdate><enddate>2021</enddate><creator>Nakano, Hiroki</creator><creator>Akashi, Naoko</creator><creator>Wada, Tomomi</creator><creator>Ide, Kyoko</creator><creator>Inoue, Atsuyuki</creator><creator>Miyabe, Takashi</creator><creator>Yamauchi, Kazutaka</creator><general>Japanese Society for Palliative Medicine</general><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>2021</creationdate><title>Off-label Medication Use of Asenapine Sublingual Tablets for Agitated Delirium in Cancer Patients at the End of Life</title><author>Nakano, Hiroki ; Akashi, Naoko ; Wada, Tomomi ; Ide, Kyoko ; Inoue, Atsuyuki ; Miyabe, Takashi ; Yamauchi, Kazutaka</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1281-2ed21096eba167ab4f1f99a69e5a3e33c347aba0d332a3f084d74af8fe03b1843</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng ; jpn</language><creationdate>2021</creationdate><topic>asenapine</topic><topic>delirium</topic><topic>terminal cancer patients</topic><toplevel>online_resources</toplevel><creatorcontrib>Nakano, Hiroki</creatorcontrib><creatorcontrib>Akashi, Naoko</creatorcontrib><creatorcontrib>Wada, Tomomi</creatorcontrib><creatorcontrib>Ide, Kyoko</creatorcontrib><creatorcontrib>Inoue, Atsuyuki</creatorcontrib><creatorcontrib>Miyabe, Takashi</creatorcontrib><creatorcontrib>Yamauchi, Kazutaka</creatorcontrib><collection>CrossRef</collection><jtitle>Palliative Care Research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nakano, Hiroki</au><au>Akashi, Naoko</au><au>Wada, Tomomi</au><au>Ide, Kyoko</au><au>Inoue, Atsuyuki</au><au>Miyabe, Takashi</au><au>Yamauchi, Kazutaka</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Off-label Medication Use of Asenapine Sublingual Tablets for Agitated Delirium in Cancer Patients at the End of Life</atitle><jtitle>Palliative Care Research</jtitle><addtitle>Palliat Care Res</addtitle><date>2021</date><risdate>2021</risdate><volume>16</volume><issue>3</issue><spage>261</spage><epage>265</epage><pages>261-265</pages><issn>1880-5302</issn><eissn>1880-5302</eissn><abstract>Delirium occurs in 30-40% of patients with terminal cancer, and 90% of patients are delirious immediately before death. Symptoms such as agitation and hallucination are often refractory to the standard pharmacological therapy. Also, the medication options for delirium in terminally ill patients are often limited due to a difficulty in swallowing or a lack of intravenous access. We herein report a case series of six patients with terminal cancer whose derilium symptoms were treated by asenapine sublingual tablets during the intervention period by the palliative care team. Asenapine was selected when other antipsychotics were ineffective or unavailable for agitation caused by delirium. All patients suffered dyspnea or choking sensations due to dysphagia or respiratory dysfunction. Sedative effect was observed among all patients without apparent adverse events. Sublingual asenapine could be an option for the management of restlessness due to terminal delirium when both oral and intravenous drug administration routes are not available.</abstract><pub>Japanese Society for Palliative Medicine</pub><doi>10.2512/jspm.16.261</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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subjects | asenapine delirium terminal cancer patients |
title | Off-label Medication Use of Asenapine Sublingual Tablets for Agitated Delirium in Cancer Patients at the End of Life |
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