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Blog articles are provided as informational purposes only and are not intended to constitute medical advice. Medication protocols are subject to patient’s medical provider’s authorization.

 

Ketamine shows promise as an effective option for hospice patients who have pain that does not fully respond to increasing doses of opioids. However, in all instances, this treatment option should be discussed and approved by the patient’s medical provider.  It may be especially useful for neuropathic pain that does not respond fully to usual pain regimens that may include, opioids, NSAIDS, certain antidepressants, anticonvulsants, and gabapentinoids.  Ketamine appears to be synergistic with opioids in patients who no longer have an analgesic response to high doses of opioids.   It is also reported to be opioid-sparing and appears to play a role in opioid potentiation.  Keep in mind the use of ketamine for pain is off-label and it can be very complex to dose, so coordination with the patient’s medical provide is critical.

Diabetes is more common in older adults due to age-related physiological changes, such as increased abdominal fat, sarcopenia, and chronic low-grade inflammation that can lead to increased insulin resistance in peripheral tissues.  In the elderly, the diabetes guidelines recommend less aggressive glycemic control.  This is due to the fact that hyperglycemia generally does not cause any acute issues.  Hyperglycemia is harmful over time for the kidneys, heart, arteries, nerves, and eyes.  As patients get older and life expectancy decreases, those long-term risks are not as significant or applicable.

 

ANCC Accreditation

ProCare HospiceCare is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation.