[Nasal application of fentanyl citrate as symptom control against breathlessness in palliative care--overview and case report].

Severe dyspnoea is the most threatening symptom of the dying and one of the main reasons for undesirable hospitalisation in end of life. Especially in home care there is a need for a noninvasive, safe and highly effective method for symptom control. Fentanyl is an appropriate drug because of its fast onset and short duration of action. Since 2003 medicated the Palliative Net Easthessia (PNO) more than 600 home care patients with nasal Fentanyl (naF). The method is simple and the user should bear in mind that the substance is highly effective. Both physician and pharmacist should inform themselves adequately before the first use about the basics of the manufacturing and use. Two typical case reports will be shown. Clinical experience let us assume that intranasal administration against dyspnoea is not inferior to the intravenous symptom control. In ambulant care caused by the use of the caring relatives or the patients themselves non-invasivity is a great advantage. Prospective studies are in need to prove the method.