Palliative care means comfort care. In palliative
medicine, doctors and nurses focus on treating the symptoms of heart failure and
other conditions so that patients can live as comfortably as possible. In heart
failure, palliative care may be requested by the doctor when a patient shows
signs or symptoms of being at the end of life. Medicines and treatment for heart
failure will remain as long as the patient can tolerate the treatments. In
addition, a focus on comfort care becomes most important. By focusing on
comfort, providers can give the best quality of life possible before death.
A key feature of palliative care is its focus on the
patient as well as the family. Chronic illness puts special stress on families,
and having support can be very helpful. Talking about and planning for the
future can help prepare a person and the person’s family to make the best
choices for everyone involved.
What are the benefits of palliative care?
High-quality palliative care can make the difference
between a comfortable existence and one that involves much suffering. Palliative
care also can help a patient’s loved ones begin to deal with the issues of grief
and bereavement.
Inotropic therapy for end-stage heart failure
Medication names
dobutamine (Dobutrex®)
milrinone (Primacor®)
Other:_____________________________
Why this medication is prescribed?
Inotropic therapy stimulates an injured or weakened
heart to pump harder. The primary purpose of this intravenous medication is to
increase the force of the heart muscle's contractions. Inotropic therapy may
also speed up the heart’s rhythm and relax blood vessels.
Inotropic therapy is used in end-stage heart failure
to help relieve and control heart failure symptoms so that you are better able to
perform your daily activities. These medications are only used when oral medication
therapies no longer control heart failure symptoms.
Special directions
- Intravenous dobutamine and milrinone infusions are
given through an infusion pump, intravenous line, and a catheter that is usually
placed in the chest or arm especially for this type of medication.
- When you are ready to leave the hospital, a home health nurse will be consulted to provide specific directions about how to care for your
intravenous site, catheter, and infusion pump.
- Be sure that you always have enough infusion bags of your medication. Check your supply before vacations, holidays, or other occasions
when you may be unable to obtain it.
- Never administer other intravenous medications through the same intravenous line.
- Take precaution to prevent infection while you are taking this medication. Your health care provider will give you information on how to
prevent infection.
Food and drug interactions
Alcohol increases the side effects of this medication and should be avoided.
Side effects and how to manage them
Notify your doctor or nurse right away the first time any of these side effects occur:
- Headache
- Vomiting
- Increased heart rate
- Shortness of breath
- High blood pressure
- Faintness, dizziness, or lightheadedness
- Nausea
- Mild leg cramps or tingling sensation
If any of these side effects occur, contact your doctor or nurse right away or call 911 and seek emergency care:
- Irregular, fast heartbeat (more than 120 beats per minute)
- Pain, bleeding, oozing, swelling, redness, or warmth at infusion site
- Fever of 101°F (38.3°C) or higher
- Pump malfunction (after contacting your doctor or nurse, call the pharmacy immediately for a replacement)
Sources
www.americanheart.org
www.hfsa.org