By: Kathryn Storm, PharmD PGY2 Pain Management and Palliative Care Pharmacy Resident VA St. Louis Health Care System & Emily Oliver, PharmD PGY2 Hospice and Palliative Care Pharmacy Resident Hospice of Southern Illinois
Steroids are commonly prescribed medications. You may know steroids as a drug that treats allergic reactions or bad colds. However, there’s more than meets the eye when it comes to this customary drug. Steroids, such as prednisone, Medrol DosePaks, hydrocortisone, and methylprednisolone, aid in a wide array of non-traditional reasons in end-of-life care.
Uses of Steroids in Hospice & Palliative Care
In palliative care, steroids manage several different symptoms associated with severe diseases during end-of-life care. In palliative and hospice care, they can help treat fatigue, pain, trouble breathing, nausea, vomiting, and poor appetite.
When terminally ill patients are feeling fatigued, steroids can help boost their energy. This can help our loved ones feel more like themselves. Therefore, increasing their ability to participate in the activities that mean the most to them. This drug also has anti-inflammatory effects, which makes them beneficial in treating certain pain conditions. Used in conjunction with other medications, such as opioids, steroids soothe pain. They can also assist with breathing issues. They work by opening up the airways in the lungs, and the anti-inflammatory properties help prevent inflammation within the lungs; thus, making breathing easier and more comfortable. Regarding nausea and vomiting, steroids are efficacious in controlling and preventing symptoms. They work by decreasing the chemicals in the brain that lead to feelings of nausea.
Lastly, they can assist patients who lose their appetite during end-of-life care. By promoting our body’s hunger signals, patients feel hungry and able to eat.
Side Effects of Steroids
As with all medications, side effects can happen. The most common side effects include weight gain, insomnia, mood changes or swings, changes in blood pressure, higher blood sugars in patients with diabetes, and fluid retention. If used for long periods, they may also increase the risk of infection.
In summary, given the wide variety of symptoms, they help manage, steroids used to treat severe disease and end-of-life care are beneficial for patients. They are generally well-tolerated and effective medications for patients in the palliative and hospice care setting. Improving the quality of life and making our loved ones more comfortable are some of the many great uses of steroids.
1. Cardenas-Mori, J., & Lewis-Ramos, V. (2020). Corticosteroids for common palliative care symptoms #395. Journal of Palliative Medicine, 23(7), 987–989.
2. Shih, A., & Jackson, K. C. (2007). Role of corticosteroids in Palliative Care. Journal of Pain & Palliative Care Pharmacotherapy, 21(4), 69–76.