Effective pain management in terminal care

Pharmacologic therapy is the mainstay of the management of pain in the terminally ill cancer patient. Upwards of 90% of cancer pain can be managed by relatively simple means (i.e. oral, rectal, or transdermal). More invasive procedures may be needed in a small percentage of patients. Effective management of pain in the elderly requires recognition of age-related changes in drug pharmacokinetics and an awareness of drug side effects that may be particularly problematic in older patients. Careful attention to the basic principles of drug use in the elderly will enhance the likelihood of effective management of pain with enhancement of quality of life for the duration of the patient's life.