Knowledge of pharmacotherapy interventions provided at the end of life is crucial to optimize care of actively dying patients. As the objective of care shifts from life-prolonging measures toward comfort measures, several challenges may arise. The use of less-familiar medications, barriers to medication administration, and inappropriate pharmacotherapy at the end of life can have deleterious results. Although goals of treatment may vary between patients, some issues related to end-of-life symptom management are common. These issues include, but are not limited to, the management of pain, death rattle/hypersecretion, delirium, agitation, and dyspnea. The ability to recognize end-of-life symptoms allows the health care professional to avoid a delay in providing maximal patient comfort. This column discusses barriers to medication administration and pharmacological agents that can be used to manage actively dying patients.

The inability to administer a medication at the end of life is a...

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