Advances in the pharmacological management of breathlessness.

PURPOSE OF REVIEW: To explore advances in the pharmacological treatment of refractory breathlessness and the physiological evidence for treatments.

RECENT FINDINGS: The evidence for the role of oral and parenteral opioids in the reduction of breathlessness continues to strengthen from individual studies and from systematic reviews. Importantly, more data are emerging about a lack of lowering in oxygenation or carbon dioxide retention with opioid therapy. In healthy volunteers and those with refractory dyspnoea, nebulized frusemide appears to be worthy of further investigation with adequately powered phase III studies.

SUMMARY: Opioids prescribed regularly can help to predictably and safely reduce breathlessness for people with a range of end-stage illnesses.