Underlying COPD: optimize use of bronchodilators, addition of steroids
Pulmonary embolism: anticoagulant
Pneumonia: antibiotics (oral route preferred).
Symptomatic measures may include the following:
Supplemental oxygen can be helpful for symptom control. Most patients prefer nasal prongs instead of facial masks.
Opioids: Systemic opioids reduce the subjective sensation of dyspnea without reducing respiratory rate or O2 saturation.
Diuretics: Patients with congestive heart failure or noncardiogenic pulmonary edema may benefit from furosemide 10 - 20 mg IV/SC.
Benzodiazepines: Have not been found in randomized controlled trials to be effective in the management of dyspnea. They can be effective in patients with specific indications, such as major anxiety episodes.
Bruera, E. & Elsayem, E. (2008). The MD Anderson Supportive and Palliative Care Handbook. Houston, Texas.
Doyle, D., Hanks, G.,Cherny, N., et al. (2003). Oxford Textbook of Palliative Medicine, Third edition. Edinburgh, UK: Oxford University Press.
Viola, R., Kileley,C., Lloyd, N.S., Mackay, J.A. et al. (2008). The management of dyspnea in cancer patients: A systematic review. Support Care Cancer;16:329-337.