Add work/symptom_management.md

work/symptom_management.md

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+# Common Medications in Hospice Care: Symptom Management
+
+## 1. Pain Management
+
+### Opioids
+- Morphine (oral, subcutaneous, IV)
+  - Often first-line for moderate to severe pain
+  - Dose titrated based on individual response
+- Oxycodone (oral, sublingual)
+  - Alternative to morphine, may cause less nausea
+- Hydromorphone (oral, subcutaneous, IV)
+  - Useful for patients with renal impairment
+- Fentanyl (transdermal patch, buccal)
+  - Patch useful for stable pain; buccal for breakthrough pain
+
+### Non-opioids
+- Acetaminophen (oral, rectal)
+  - For mild pain or as opioid-sparing agent
+- NSAIDs (oral, rectal)
+  - Used cautiously due to potential side effects
+
+## 2. Anxiety and Agitation
+
+### Benzodiazepines
+- Lorazepam (oral, sublingual, IV)
+  - Fast-acting, useful for acute anxiety or agitation
+- Midazolam (subcutaneous, IV)
+  - Often used for terminal restlessness
+
+### Antipsychotics
+- Haloperidol (oral, subcutaneous, IV)
+  - Low doses effective for anxiety and nausea
+- Quetiapine (oral)
+  - May be preferred in elderly due to less extrapyramidal effects
+
+## 3. Nausea and Vomiting
+
+- Ondansetron (oral, sublingual, IV)
+  - Effective for chemotherapy-induced nausea
+- Metoclopramide (oral, subcutaneous, IV)
+  - Also improves gastric motility
+- Haloperidol (oral, subcutaneous, IV)
+  - Effective for opioid-induced nausea
+
+## 4. Respiratory Issues
+
+- Albuterol (inhaled)
+  - For wheezing or breathlessness
+- Glycopyrrolate (oral, subcutaneous)
+  - Reduces respiratory secretions
+- Scopolamine (transdermal patch)
+  - Alternative for secretion management
+
+## 5. Secretion Management
+
+- Atropine (sublingual drops)
+  - Rapid onset for acute secretion management
+- Hyoscyamine (sublingual)
+  - Longer-acting alternative to atropine
+
+## 6. Delirium
+
+- Haloperidol (oral, subcutaneous, IV)
+  - First-line treatment, careful dose titration needed
+- Risperidone (oral, sublingual)
+  - Alternative to haloperidol, may have fewer side effects
+
+## 7. Sleep Disturbances
+
+- Zolpidem (oral)
+  - Short-term use for insomnia
+- Trazodone (oral)
+  - May be preferred due to less potential for dependence
+
+Note: Medication choices and routes of administration are individualized based on patient needs, preferences, and ability to swallow. Doses are carefully titrated and adjusted based on symptom control and side effects. This list is not exhaustive, and other medications may be used depending on specific patient situations and local practices.