Medical

Medications. As patients approach death, reassess the need for each medication and minimize the number of drugs that the patient is taking. Continue only those medications needed to manage symptoms such as pain, breathlessness, excess secretions, and terminal delirium and to reduce the risk of seizures. Choose the least invasive route of administration: the buccal mucosa or oral routes first, the transcutaneous route if appropriate, the subcutaneous or intravenous routes only if necessary, and the intramuscular route almost never. Rectal administration can also be considered, especially if the oral route is not possible. http://cme.medscape.com/viewprogram/5808 ( The last hrs of dying/ A practical approach to Physicians).