Você está na página 1de 15

:fej\ejf9iXj`c\`if[\E}lj\Xj\Md`kfj

)'((

(

SUPLEMENTO 2

Revista Brasileira de Cuidados Paliativos 2011; 3 (3) - Suplemento 2

Re v i s t a

B r a s i l e i r a

d e

C u i d a d o s

Pa l i a t i v o s

2 011;

(3)

S u p l e m e n t o

:fej\ejf9iXj`c\`if[\E}lj\Xj\Md`kfj

)'((

*

SUPLEMENTO 2
CONSENSO BRASILEIRO DE NUSEAS E VMITOS
PREMBULO

C7cbgYbgc6fUg]`Y]fcXYBzigYUYJa]hchYjY
Wcac cV^Yh]jc U VigWU XU aY`\cf UVcfXU[Ya  dUfU
]XYbh]WU~cXcgZUhcfYgYh]c`[]Wcg cYbhYbX]aYbhc
XUg]cdUhc`c[]UYbjc`j]XUYUdfcdcg]~cXYaY`\cfYg
]bhYfjYbYg X]gdcbjY]g dUfU c hfUhUaYbhc Y U
dfYjYb~cXUbzigYUYja]hcYadUW]YbhYgWcaW|bWYf
YaWi]XUXcgdU`]Uh]jcg":cfUafYU`]nUXUg)FYib]Yg
. Ya  &( XY gYhYaVfc  bc F]c XY >UbY]fc  Ya ( XY
XYnYaVfcXY&$%$ Ya)XYZYjYfY]fcY%$XYUVf]`XY
&$%%  bU W]XUXY XY  G~c DUi`c" Cg [fidcg XY YghiXc
ZcfUa X]j]X]Xcg XU gY[i]bhY ZcfaU. 8YZ]b]~c Y
8]U[bgh]Wc  5jU`]U~c Y ;fUXU~c  AYX]WUaYbhcgc 
AYX]W]bUg 7cad`YaYbhUfYg Y Dfzh]WUg =bhY[fUh]jUg
YDYX]Uhf]UY"CgaYaVfcghfUVU`\UfUa XYaUbY]fU
]bhYfX]gW]d`]bUf fYdfYgYbhUbXcgiUg]bgh]hi]YgYYa
giV[fidcg cf]YbhUXcgdcfia7ccfXYbUXcfXY;fidc
GYWfYhzf]U 7ccfXYbUXcf;YfU`YFYj]gcf7]YbhWc"
HU` 7cbgYbgc Zc] iaU ]b]W]Uh]jU XU 5ggcW]U~c
6fUg]`Y]fU XY 7i]XUXcg DU`]Uh]jcg  eiY dfcWifci
fYib]fhcXcYeiU`eiYfUdc]c]bgh]hiW]cbU` VYaWcac
cUjU`XUg=bgh]hi]YgfYdfYgYbhUXUg Ygh]ai`UbXc
UgX]gWiggYgYbhfYcgaYaVfcgUei]Z]`]UXcg UZ]a
XYXUffYU``Y[]h]a]XUXYUc7cbgYbgc"

MEMBROS:

5@8C 89H H=BC  cbWc`c[]ghU  <cgd]hU` 5"7"


7UaUf[c GD/5B5;9CF;=575J5@75BH=89A9@C 
Dg]W`c[U 7ca]gg~c8]fYhcfU 5ggcW]U~c6fUg]`Y]fU
XY7i]XUXcgDU`]Uh]jcg GD/5B5@I7=57CF585NN= 
CbWc`c[]ghU  <cgd]hU` 5aUfU` 7UfjU`\c >U  GD/
5IFC89@;=;@=C cbWc`c[]ghU :A567 5ggcW]U~c
6fUg]`Y]fUXY7i]XUXcgDU`]Uh]jcg/69F9B=79A5F=5
K9F@9 ;Yf]UhfU <cgd]hU`Ac]b\cgXYJYbhc Dcfhc
5`Y[fY FG/75F=B55@A9=85ACF5=G bihf]W]cb]ghU 
=79GD  GD/ 75F@5 ;CBu5@J9G 8=5G  YbZYfaY]fU 
75FC@=B9 <5B9A5BB  bihf]W]cb]ghU 5D57B DF/
75FC@=B9 A"5CEI=  ZUfaUWih]WU  <cgd]hU` Gf]c
@]VUbg GD/7vG5F5BHCB=CD=BHC Z]g]chYfUdYihU 
=79GD  GD/7=69@9 5B8FI7=C@@= A5HHCG D=A9BH5 
YbZYfaY]fU 99IGD/=CD#;F5577/8@9H98"ACH5 
YbZYfaY]fU Ib]jYfg]XUXYXY;c]|b]U ;C/85B=9@5
57<9H H9  dg]W`c[U  <cgd]hU` Gf]c @]VUbg 
GD/85B=9@56CB:=9HH=FC8F=;I9G YbZYfaY]fU =CD#
;F5577/8=F79D9F=GG=BCHH= dg]W`c[U <7:AIGD 
GD/ 98I5F8C ;I=@<9FA9 8 5@9GG5B8FC 

W`b]WU aX]WU Y UWidibhifU  =79GD  GD /9@=5B5


75F5B  cbWcdYX]UhfU  =CD#;F5577  GD/9@=5B9
G5BHCG :9FB5B89G YbZYfaY]fU cbWc`[]WU 
<cgd]hU` <Y`]dc`]g  GD/9@=G569H< @IN ACF9=F5
8CG G5BHCG  [Yf]UhfU  <cgd]hU` Ac]b\cg XY
JYbhc  Dcfhc 5`Y[fY  FG/ 9@CG5 6CB9HH= 9GD585 
UbYghYg]c`c[]ghU <7:AIGD GD/:F5B?@=BG5BH5B5
G5BHCG  [Yf]UhfU  567D/ ;v@7=C @I=N EI=BH9@@5
A9B89G cbWc`c[]ghU <7:!AG#=B75!AG F>/<9@9B5
D98FCG5 dg]W`c[U <9ACD9 D9/=F=A5F89D5I@5
DCGGC UbYghYg]c`c[]ghU <7:AIGD GD/>I@=5B58CG
G5BHCG89C@=J9=F5 CbWc`c[]ghU <cgd]hU`5aUfU`
7UfjU`\c >U GD/?5F=B95N9J98C@9C YbZYfaY]fU 
<7:AIGD  Ib;  =79GD/?5F@5 5@6IEI9FEI9 
YbZYfaY]fU  Ib]jYfg]XUXY XY DYfbUaViWc  D9 
@J=5 7F=GH=B5 J=5B5 dg]W`c[U  =CD/;F5577 GD/
A5F=5 G5@CAv 89 5;I=5F 5B8F589  dg]W`c[U 
<9ACD9 D9/A5F7=5ACF9HH9 YbZYfaY]fU <cgd]hU`
=gfUY`]hU 5`VYfh 9]bghY]b  GD/A5F=5 5IL=@=58CF5
7F5=7969B989HHC W]fif[]U[YfU` GC6F5A:5 GD/
A5F=B5F57<9@;F5A=B<57IFM dg]W`c[U =CD##
;F5577 GD/A5IF7=CA9BB565FF9HC!;Yf]UhfU
!=bgh]hihcXY;Yf]Uhf]UY;Yfcbhc`c[]UXUDI7FG#FG/
B=@C9";5F8=B \caYcdUhU 5gg"6fUg"XYAYX]W]bU
5bhfcdcgZ]WU/ DF=G7=@5 8CG G5BHCG A5=5 
bihf]W]cb]ghU =CD#;F5577 GD/F=75F8C75DCB9FC 
cbWc`c[]ghU  7`b]WU XY CbWc`c[]U AX]WU  567D 
GD/ F=H5 89 7GG=5 A57=9=F5  dg]W`c[U  G6DC 
G D /  F C 6 9 F H 5  F = ; C  8 5 @ 5 7 C F H 9 ; Y f ] U h f ] U  Y
5WidibhifU =bgh]hihc XY ;Yf]Uhf]U Y ;Yfcbhc`c[]U
XUDI7FG FG FCG5B9F5::5=B=D5@A5 dg]W`c[U
 G6DC  567D/GD/FCGA5F= K=H HA5B J=9=F5 
YbZYfaY]fU  <cgd]hU` XUg 7`b]WUg XY Dcfhc 5`Y[fY 
DC5  FG/ G5B8F5 75=F9G G9FF5BC  cbWc`c[]ghU 
<cgd]hU`5"7"7UaUf[c GD/G<9=@5C@=J9=F5:5F=5 
bihf]W]cb]ghU  =79GD  GD/G=ACB9 C@=J9=F5 D5G=B 
YbZYfaY]fU  <cgd]hU` XUg 7`b]WUg XY Dcfhc 5`Y[fY 
FG/ GD/ GH9D<9B 8CF5@ GH9:5B=  cbWc`c[]ghU 
<cgd]hU` A~Y XY 8Yig  Dcfhc 5`Y[fY  FG  GIN9H9
J5F9@5 A5MC  cbWcdbYiac`c[]ghU  <cgd]hU`
<Y`]dc`]g  GD/ H<5=G 89 75ADCG 75F89B5G 
bihf]W]cb]ghU =79GD/H<9C8CF5?5FB5?=G [Yf]UhfU 
<cgd]hU`=gfUY`]hU5`VYfh9]bghY]b GD/HCG<=C7<=65 
[Yf]UhfU  =79GD  GD/ J5B9GG5 89 ACF5=G ACIF5 
bihf]W]cb]ghU =79GD GD/J=J=5B95D5F97=85@9GG5 
Z]g]chYfUdYihU <cgd]hU`<Y`]dc`]g GD

7ccfXYbUXcf;YfU`.
F]WUfXc7UdcbYfc CbWc`c[]ghU7`b]Wc YlDfYg]XYbhY5ggcW]U~c6fUg]`Y]fUXY7i]XUXcgDU`]Uh]jcg
FYj]gcf7]YbhWc.
B]`c9";UfX]b <caYcdUhU 5ggcW]U~c6fUg]`Y]fUXY7i]XUXcgDU`]Uh]jcg
GYWfYhzf]U.
5bU;Ycf[]U7UjU`WUbh]XYAY`c 7ca]gg~c8]fYhcfUXU5ggcW]U~c6fUg]`Y]fUXY7i]XUXcgDU`]Uh]jcg

5[fUXYW]aYbhcg5AG8dY`cUdc]cZ]bUbWY]fcfYghf]hcUdYbUgUj]UV]`]nU~ccdYfUW]cbU`XYghY7cbgYbgc

Re v i s t a

B r a s i l e i r a

d e

C u i d a d o s

Pa l i a t i v o s

2 011;

(3)

S u p l e m e n t o

)'((

:fej\ejf9iXj`c\`if[\E}lj\Xj\Md`kfj

:fej\ejf9iXj`c\`if[\E}lj\Xj\Md`kfj

SUPLEMENTO2
5Cf[Ub]nU~cAibX]U`XYGUXYXYbYcgWi]XUXcg
dU`]Uh]jcg Wcac iaU UVcfXU[Ya eiY aY`\cfU U
eiU`]XUXYXYj]XUXcdUW]YbhYYgYigZUa]`]UfYgZfYbhY
U ia dfcV`YaU UggcW]UXc U XcYbUg Wca f]gWc XY
acfhY UhfUjgXUdfYjYb~cYU`j]cXcgcZf]aYbhcdcf
aY]cXY]XYbh]WU~cdfYWcWY UjU`]U~cYhfUhUaYbhc
]adYWzjY]g XU Xcf Y XY cihfcg dfcV`YaUg Zg]Wcg 
dgei]WcgYYgd]f]hiU]gCAG &$%%"
7UXUjYnaU]gcgWi]XUXcgdU`]Uh]jcgg~cbYWYggzf]cg
bUUhYb~cXifUbhYchfUhUaYbhcXYX]jYfgUgWcbX]Yg
YYgdYW]U`aYbhYbcaXUj]XU"
BzigYUg Y ja]hcg Ygh~c YbhfY cg g]bhcaUg aU]g
Wcaibg Y cg eiY aU]g UZYhUa U eiU`]XUXY XY j]XU
XYdYggcUgeiYbYWYgg]hUaXYWi]XUXcgdU`]Uh]jcg"5
fch]bUX]zf]UXYggYgdUW]YbhYghcfbU!gYdfcZibXUaYbhY
UZYhUXUdcfYggYgg]bhcaUg ceiY^igh]WUUbYWYgg]XUXY
XYgYiaUbY^cYWUndcfdUfhYXcdfcgg]cbU`XYgUXY
F\cXYgAW8Ub]Y` &$$%"

C X]U[bgh]Wc XY ja]hc hUaVa gY VUgY]U bU


\]ghf]UW`b]WU gYbXc]adcfhUbhYUeiUbh]WU~cXcg
Yd]gX]cg Y Xc jc`iaY YldY`]Xc Ya WUXU ia XY`Yg"
5 UjU`]U~c Xc YghUXc bihf]W]cbU` Y XY \]XfUhU~c
hUaVaXYjYgYffYU`]nUXU"
IaUjYn]XYbh]WUXUUdfYgYbUXYiaciUaVcg
cgg]bhcaUg ]adYfUh]jcXYb]f!gYUYh]c`c[]UdUfUc
hfUhUaYbhcUXYeiUXc"5HUVY`U%XYgWfYjYcgdf]bW]dU]g
X]U[bgh]WcgX]ZYfYbW]U]g"

HUVY`U%"7UigUgXYbzigYUgYja]hcg"
;Ughf]bhYgh]bU]g

7UbX]XUgYcfcZUfb[YU
;UghfcdUfYg]U
7cbgh]dU~cYcVghfi~c]bhYgh]bU`

8fc[Ug

Cd]c]XYg
5bh]V]h]Wcg
5bh]!]bUaUhf]cgb~cYghYfc]XU]g
8][cl]bU
:Yffc

DEFINIO

BzigYUUgYbgU~cXYgU[fUXzjY`XUbYWYgg]XUXY
XY jca]hUf  \UV]hiU`aYbhY UWcadUb\UXU XY
g]bhcaUgUihcba]WcgWcacgiXcfYgYZf]U g]U`cff]U 
\]dchcb]U [zghf]WU  fYZ`ilc Xc WcbhYXc ]bhYgh]bU`
dUfUcYghaU[c YbhfYcihfcg"Ja]hcciaYgY
U Yldi`g~c fzd]XU Y ZcfUXU Xc WcbhYXc [zghf]Wc
UhfUjg XU VcWU  WUigUXU dcf iaU WcbhfU~c ZcfhY
Y gighYbhUXU XU aigWi`UhifU XU dUfYXY hcfzW]WU Y
UVXca]bU`AcffckFcgYbh\U` %--*"
BzigYU WcffYgdcbXY { df]aY]fU ZUgY XU aYgY  c
YghaU[c gY fY`UlU Y cWcffY U ]b]V]~c XU gYWfY~c
XczW]Xc[zghf]WcYghUW\UaUXUXYZUgYdf!Y^Y~c"
8ifUbhY U bzigYU U dfYgg~c ]bhfUhcfzW]WU X]a]bi] Y
U dfYgg~c UVXca]bU` UiaYbhU" C dUggc gY[i]bhY  U
ZUgYXYY^Y~c.cfYYlcXcja]hcWcadfYYbXYiaU
[fUbXYWcbhfU~cfYhf[fUXUXc]bhYgh]bcXY`[UXcdUfU
cYghaU[c/WcbhfUYgXcgagWi`cgUVXca]bU]gYXc
X]UZfU[aUhcfbUa!gYWccfXYbUXcg UiaYbhUUdfYgg~c
bc hfUl Y bc UVXcaY Wcadf]a]bXc c YghaU[c Y
ZcfUbXc gYi WcbhYXc UhfUjg XU VcWU Y bUf]n" BU
ZUgYXYdg!Y^Y~c[YfU`aYbhY\zU`j]cXUbzigYUU
XYdYbXYfXUYh]c`c[]UXcdfcWYggc"
5aVcg cg g]bhcaUg g~c UggcW]UXcg { gYbgU~c
XYgWcbZcfhzjY` Wca]adUWhc]adcfhUbhYbUeiU`]XUXY
XYj]XUAUbb]l %--,"

DIAGNSTICO

E ETIOLOGIA
5dfYjU`bW]UXYbzigYUgYja]hcgYadUW]YbhYg
WcaW|bWYf]bWifzjY`XY'%Y&$fYgdYWh]jUaYbhY
HYib]ggYb Yh U`"  &$$+" 9a YghiXc ai`h]Wbhf]Wc 
JU]b]c  5ij]bYb %--* YbWcbhfUfUa Ug aU]cfYg
hUlUg XY dfYjU`bW]U XYggYg Xc]g g]bhcaUg YbhfY
dUW]YbhYg gcV Wi]XUXcg dU`]Uh]jcg bcg hiacfYg eiY
UZYhUa U WUj]XUXY UVXca]bU`. W|bWYf []bYWc`[]Wc
(&  [zghf]Wc '*  YgcZz[]Wc &* Y Wc`cffYhU`
&&"8YghYacXc dUW]YbhYgWcaYggYgX]U[bgh]Wcg
XYjYa gYf Wcbg]XYfUXcg XY aU]cf f]gWc dUfU c
XYgYbjc`j]aYbhcXcgg]bhcaUgYYbh~cc]bhYffc[Uhf]c
X]fYW]cbUXc dUfU giU XYhYW~c XYjY ZUnYf dUfhY XU
UjU`]U~cW`b]WUfch]bY]fU"
C X]U[bgh]Wc XY bzigYU  W`b]Wc  VUgYUXc bU
\]ghf]U fY`UhUXU dY`c dUW]YbhY Y gYig ZUa]`]UfYg 
iaU jYn eiY gY hfUhU XY iaU gYbgU~c giV^Yh]jU" v
]adcfhUbhY eiYgh]cbUf c dUW]YbhY U fYgdY]hc XY gYi
XYgY^cXYgYU`]aYbhUf gYbgU~cXYZfUeiYnU YjYbhiU`
X]Wi`XUXYaYW|b]WUdUfUXY[`ih]f dfYgYbUXYgYXY
Y#ciZcaY fYU~cUXYhYfa]bUXcgU`]aYbhcgYcXcfYg 
Y ZUhcfYg XYgYbWUXYUbhYg Xc g]bhcaU" 5 UjU`]U~c
Xc YghUXc bihf]W]cbU` Xc dUW]YbhY Y Xcg g]bU]g XY
XYg]XfUhU~c dcXY Wcbhf]Vi]f dUfU c X]U[bgh]Wc XY
bzigYUgWfb]WUgY#ci]bhYbgUg"

B r a s i l e i r a

,

SUPLEMENTO 2

INTRODUO

Re v i s t a

)'((

d e

C u i d a d o s

AYhUV`]WU

<]dYfWU`WYa]U
=bgiW]bW]UfYbU`

Hcl]W]XUXY

Ei]a]chYfUd]U
FUX]chYfUd]U
=bZYW~c
GbXfcaYdUfUbYcd`zg]WU

BYifc`[]WU

! AYhzghUgYg bc g]ghYaU bYfjcgc WYbhfU`" =bXU[Uf


gcVfY WYZU`Y]U  jYfh][Ya  Wcbji`gYg  XW]h achcf
`cWU`]nUXc U`hYfUYgXUj]g~cYXUaUfW\U"DfcWYXYf
ZibXcgWcd]U gYUWYggjY`"
!Dg]Wcggcazh]Wcg"7cbg]XYfUfWUigUdg]Wc`[]WUbcg
dUW]YbhYgYaeiYbYb\iaUXUgWUigUgUbhYf]cfYgZc]
Yj]XYbW]UXU VYaWcacbUeiY`YgWcaUbhYWYXYbhYgXY
hfUbghcfbcWcadcfhUaYbhU`Y#ciXc\iacf"

FISIOPATOLOGIA

CWcb\YW]aYbhcXcgaYWUb]gacgZ]g]cdUhc`[]Wcg
dYfa]hY c hfUhUaYbhc Wca Xfc[Ug eiY UhiYa Ya
fYWYdhcfYg YgdYWZ]Wcg  Ygh]ai`UXcg ci ]b]V]Xcg XY
UWcfXcWcaUgX]ZYfYbhYgYh]c`c[]UgXUgbzigYUgY#ci
ja]hcg:]["%"
! 7cbg]XYfUYg UbUha]WUg" 5 zfYU dcghfYaU 
iaU YghfihifU W]fWibjYbhf]Wi`Uf  `cWU`]nUXU bc
d]gc Xc eiUfhc jYbhfWi`c  bc hfcbWc WYfYVfU`"
HfUhU!gY XY Ybh]XUXY ZibW]cbU`  XYbca]bUXU ncbU
XY [Uh]`\c ei]a]cffYWYdhcfU  Ybjc`hU dcf VUffY]fU
\YaUhcYbWYZz`]WUdYfaYzjY` ceiYUhcfbUgYbgjY`U
giVgh|bW]Ug dchYbW]U`aYbhY YaYhc[b]WUg dfYgYbhYg
bUW]fWi`U~cgUb[ibYU"
CWYbhfcXcja]hcWUdfl]ac{zfYUdcghfYaU 
bU aYXi`U Ygd]b\U`" 5[Y Wcac j]U Wcaia bc
dfcWYggUaYbhc XY X]ZYfYbhYg Yghai`cg UZYfYbhYg 
dfcacjYbXccja]hc"
!7cbg]XYfUYgeia]WUgbYifc`[]WUgWYbhfU]gHUV"
& KUhgcb  &$$)/ CDG  &$$(/ @dYn Yh U`"  &$$)" Cg
fYWYdhcfYgh]dc&XUXcdUa]bU8&XUzfYUdcghfYaU
g~cYgh]ai`UXcgdcfU`hUgWcbWYbhfUYgd`Ugazh]WUg
XYgiVgh|bW]UgYaYhc[b]WUg hU]gWcaccbgXYWz`W]c 
acfbU  ifY]U Y X][cl]bU" 5 zfYU dcghfYaU hUaVa
dcXY gYf Uh]jUXU dcf Yghai`cg UZYfYbhYg Xc bYfjc

HUVY`U&"AYWUb]gacXYU~cWYbhfU`XUgbzigYUgYja]hcg"
AYWUb]gac

AYhzghUgYg Ya g]ghYaU bYfjcgc


WYbhfU`

5Yh]c`c[]UXYbzigYUgYja]hcggYadfYgi[Yf]XU
dY`U\]ghf]UW`b]WU dcfaXYUWcfXcWcaUgigdY]hU
XYjY!gY ]b]W]Uf iaU ]bjYgh][U~c Wcad`YaYbhUf 
WcbZcfaYgi[Ygh~cUgY[i]f"
! 9h]c`c[]U [Ughf]bhYgh]bU`" =bXU[Uf gcVfY X]gZU[]U Y
dfcWYXYfYlUaYUXYeiUXcXUWUj]XUXYcfU`"5Wf]hf]c
W`b]Wc  U YbXcgWcd]U X][Ygh]jU U`hU dcXY gYf h]`"
EiYgh]cbUfc\zV]hc]bhYgh]bU` ]bW`i]bXcY`]a]bU~c
XY [UgYg Y ZYnYg" 9lUa]bUf dcf Wcad`Yhc c UVXcaY.
]bgdY~c dU`dU~c dYfWigg~cYUigWi`hU YaVigWUXY
g]bU]gYg]bhcaUgXYcVghfi~c]bhYgh]bU` dcXYbXc!gY
X]ZYfYbW]Uf X]ghYbg~c [UgcgU XY UgW]hY" BYggYg WUgcg
U ]bjYgh][U~c fUX]c`[]WU Xc UVXcaY dcXY YghUf
]bX]WUXU" BU gigdY]hU XY cVghfi~c ]bhYgh]bU` dcf
]adUWhU~cZYWU` chceiYfYhU`]adcfhUbhY"
! 8fc[Ug" =bXU[Uf gcVfY aYX]WUYg Ya igc Y
giUUggcW]U~cWcac]bW]cXceiUXfcXYbzigYUg
Yja]hcg"
! AYhUV`]WUg" EiYgh]cbUf gcVfY \zV]hc if]bzf]c 
aYX]WUYgYaigcYgc`]W]hUfXcgU[Yagf]WUXYifY]U 
WfYUh]b]bUYY`Yhf`]hcgeiUbXc]bX]WUXU"
!Hcl]bUg"=bXU[UfgcVfYhfUhUaYbhcgcbWc`[]WcgYa
WifgcfUX]chYfUd]U ei]a]chYfUd]UYgiUUggcW]U~c
Wca c ]bW]c Xcg g]bhcaUg" =bXU[Uf gcVfY ZYVfY 
gif[]aYbhcciaiXUbUXcUgdYWhcXcYgWUffc X]gf]U
Y cihfcg g]bhcaUg gi[Ygh]jcg XY ]bZYW~c" Gc`]W]hUf
YlUaYgWcad`YaYbhUfYgWcbfaYUgigdY]hUW`b]WU"
2 011;

(3)

S u p l e m e n t o

5~cWYbhfU`aYX]UXcf

5bg]YXUXY
9ghfYggY
8cf
@ihc
<]dcbUhfYa]U
<]dYfhYbg~c]bhfUWfUb]UbU

Dg]Wcggcazh]Wcg 5bg]YXUXY
AYXc

Pa l i a t i v o s

jU[cYXcUdUfY`\cjYgh]Vi`Uf":]VfUgjU[U]ghUaVa
dcggiYafYWYdhcfYg)!\]Xfcl]hf]dhUa]bU)!<H'"
! 7cbg]XYfUYg eia]WUg bYifc`[]WUg dYf]Zf]WUg" C
hfUhc[Ughf]bhYgh]bU`X]gdYXYfYWYdhcfYgdfcachcfYg
XYYghai`cgUZYfYbhYgUVXca]bU]gj]UjU[U` WUdUnYg
XYXYgYbWUXYUfcfYYlcYaYhc[b]WcUdgYldcg]~c{
ei]a]chYfUd]U fUX]chYfUd]U X]ghYbg~cUVXca]bU`YhW"
Cg df]bW]dU]g fYWYdhcfYg ]bhYgh]bU]g Ybjc`j]Xcg
bc dfcWYggc g~c )!<H'  bYifcei]b]bU  XcdUa]bU Y
Wc`YW]ghcei]b]bU  `cWU`]nUXcg bUg hYfa]bUYg Xcg
UZYfYbhYg jU[U]g" HU]g fYWYdhcfYg g]hiUa!gY dfl]acg
{gW`i`UgYbhYfcWfcaUbgXUaiWcgU[Ughf]bhYgh]bU` 
Wcb[ifUbXciaUf]WUZcbhYXY)!<H' eiY`UbUXc
aUgg]jUaYbhYUdUfh]fXYggUgW`i`UgYafYgdcghUUcg
X]jYfgcgYghai`cgYgYbg]V]`]nUcgUZYfYbhYgjU[U]g"
! Cd]c]XYg" 5 aU]cf]U Xcg fYWYdhcfYg fY`YjUbhYg
bcWYbhfcXcja]hcg~cYlW]hUhf]cg ]ghc WUigUa
bzigYUg Y ja]hcg eiUbXc Ygh]ai`UXcg" 5 df]bW]dU`
YlWY~ccfYWYdhcf!cd]c]XY eiY]b]V]Xcf"
CdUdY`Xcgcd]c]XYgbUg]cdUhc`c[]UXUaYgY
dUfUXclU`"GYidchYbW]U`Ubh]Yah]WcWcadYbgUXc
dcfgYi]adUWhcYah]WcbUzfYUdcghfYaU"CYei]`Vf]c
YbhfYUgXiUgUYg dfcjUjY`aYbhY XYdYbXYbhYXU
XcgY"8cgYg\UV]hiU]gXYcd]c]XYgg~cZfYeiYbhYaYbhY
YaYhc[b]WUgXYj]Xc{Ygh]ai`U~cXYfYWYdhcfYg8&
bUzfYUdcghfYaU UcdUggceiYXcgYgai]hcY`YjUXUg
dcXYab~cXYgYbWUXYUfcaYgacYZY]hc"
Cd]c]XYg U`hUaYbhY `]dcggc`jY]g  Wcac ZYbhUb]`
Y aYhUXcbU  dcXYa gYf aYbcg YaYhc[b]Wcg eiY U
acfbU dc]gUhfUjYggUaUVUffY]fU\YaUhcYbWYZz`]WU
aU]g fUd]XUaYbhY Y  dcfhUbhc  YlYfWYa ia aU]cf
YZY]hcUbh]Yah]Wc"HYcf]WUaYbhY dUW]YbhYggYbgjY]g
Ucg YZY]hcg YaYhc[b]Wcg XU acfZ]bU dcXYf]Ua gY
VYbYW]UfXUfchU~cXYcd]c]XYg"

5~cbU`

7fhYlWYfYVfU`
;565 )!<H

Acj]aYbhcg

BW`YcgjYgh]Vi`UfYg
57H<!a/<%

IfYa]U
<]dYfWU`WYa]U
8fc[Ug

NcbUXY[Uh]`\c
ei]a]cffYWYdhcfU
)!<H'/8&

8]ghYbg~cci
YghUgY[zghf]WU
7cbgh]dU~ccicVghfi~c
]bhYgh]bU`
7cadfYgg~cYlhfbgYWU
8fc[Ug

FYWYdhcfYgXU
dUfYXY]bhYgh]bU`
)!<H'

7YbhfcXcja]hc
:cfaU~c
fYh]Wi`Uf
<%/57H<!a

5ZYfYbhYg
jU[U`Yg]adzh]Wc

)!<H.gYfchcb]bU/)!<H'.)!\]Xfcl]hf]dhUa]bU/57H<!a.UWYh]`Wc`]bUaigWUfb]WU/8.XcdUa]bU/<%.\]ghUa]bU/
;565.W]Xc[UaU!Ua]bcVihf]Wc"
2

Re v i s t a

B r a s i l e i r a

d e

C u i d a d o s

Pa l i a t i v o s

2 011;

(3)

S u p l e m e n t o

)'((

:fej\ejf9iXj`c\`if[\E}lj\Xj\Md`kfj

:fej\ejf9iXj`c\`if[\E}lj\Xj\Md`kfj

SUPLEMENTO2

)'((

.

SUPLEMENTO 2
CLASSIFICAO

BzigYUgYja]hcgdcXYagYfW`Ugg]Z]WUXcgWcac
YjYbhcgU[iXcg hUfX]cg fYZfUhzf]cg UbhYW]dUhf]cg
YXYYgWUdY"
5aYgYU[iXUcWcffYbUgdf]aY]fUg&(\cfUgUdg
gYiYgh]ai`cYdUfYWYgYfaYX]UXUdY`UgYfchcb]bU"5
aYgYhUfX]UcWcffYUdg&(\cfUgXcgYiYghai`cY
dcXYdYfg]gh]fdcfeiUhfcUgY]gX]Ug"BzigYUYja]hcg
UbhYW]dUhf]cgcWcffYahYadcfU`aYbhY`cb[YXYgYi
Yghai`cYdcXYagYfXYgYbWUXYUXcgdcf`YaVfUbUg
Xc hfUhUaYbhc ci Xc UaV]YbhY Ya eiY cWcff]U c
Yghai`cYaYhc[b]Wc"CgfYZfUhzf]cgg~cUeiY`YgeiY
cWcffYaUdYgUfXUgaYX]XUgdfc`zh]WUgYhYfUdih]WUg
]bgh]hiXUg?f]gYhUh" &$$*"

AVALIAO

E GRADAO
v ZibXUaYbhU` eiY c dfcZ]gg]cbU` XY gUXY
e i Y g h ] c b Y  Y g d Y W ] Z ] W U a Y b h Y  c g  g ] b h c a U g  b c
acaYbhcXUUjU`]U~c dc]gcdUW]YbhYWcabzigYU
Wfb]WU dcXY b~c gY eiY]lUf" Cg ja]hcg g~c
ZUW]`aYbhY ]XYbh]Z]WUXcg  Y Ugg]a X]U[bcgh]WUXcg
YhfUhUXcgGUlVm &$$+"
BzigYUgYja]hcgYgh~cdfYgYbhYgYa*U*,Xcg
dUW]YbhYg Wca W|bWYf  Y Ya '$ U )$ Xcg dUW]YbhYg
Wca gbXfcaY XU ]aibcXYZ]W]bW]U UXei]f]XU
5=8G#G=85 ]bgiW]bW]UWUfXUWUYfYbU`;fidcXY
HfUVU^cXY`U;iUXYDfzWh]WU7`b]WUgcVfY7i]XUXcg
DU`]Uh]jcg  &$$," 8Y acXc [YfU`  WYfWU XY )$ Xcg
dUW]YbhYg Ya Wi]XUXcg dU`]Uh]jcg UdfYgYbhUa YggYg
g]bhcaUgG]`jUG]`jU &$$*"
DUfUiaUUXYeiUXU]bjYgh][U~cZUn!gYbYWYggzf]c
Wcb\YWYfcXcYbhYYcUbXUaYbhcXYgiUXcYbU cg
hfUhUaYbhcg fYU`]nUXcg Y cg aYX]WUaYbhcg Ya igc 
VYaWcacUdfYgYbUXYcihfcgg]bhcaUg"
5 UjU`]U~c XUg bzigYUg Y ja]hcg Ybjc`jY U
]bjYgh][U~c XU ZfYeibW]U  XifU~c  ]bhYbg]XUXY 
UgdYWhc  jc`iaY  ZUhcfYg WUigUXcfYg ci U[fUjUbhYg
Wcac c igc XY aYX]WUaYbhcg  XYgWcbZcfhc Zg]Wc 
gcW]U` YacW]cbU` bUbWY]fc YZYh]j]XUXYYgUh]gZU~cYa
fY`U~cUchfUhUaYbhcdfcdcghc7F9A9GD &$$,"
5 UjU`]U~c WcbhbiU Y g]ghYazh]WU dcgg]V]`]hU c
UWcadUb\UaYbhc XU Yjc`i~c Xc eiUXfc  gYbXc
ZibXUaYbhU`gYifY[]ghfc"5dUfh]fXUUjU`]U~cdcggjY`
d`UbY^Uf]bhYfjYbYgYhfUhUaYbhcgj]gUbXccWcbZcfhc"
CgWcadcbYbhYgXUUjU`]U~cgY[iYaUVU]lc"
<]ghf]WcXUXcYbUYXUgbzigYUgYja]hcg.
! 7cbX]Yg Z]g]cdUhc`[]WUg Wcac. UWY]hU~c
U`]aYbhUf  ZfYeibW]U Wca eiY cWcffYa  ZUhcfYg
XYgYbWUXYUbhYg ci U[fUjUbhYg  Wc`cfU~c Y UgdYWhc
Xcgja]hcgZYWU`c]XY V]`]Uf U`]aYbhUf `ei]XcXY
YghUgY  \zV]hc ]bhYgh]bU` Wcbg]ghbW]U  ZfYeibW]U
Y eiUbh]XUXY XUg YjUWiUYg  dfYgYbU ci b~c
XY g]bhcaUg dfcXfa]Wcg" Ja]hc XYgYbWUXYUXc
dcf \]dYfhYbg~c ]bhfUWfUb]UbU Y aYb]b[]gac  dcf
YlYad`c UdUfYWYgYadfXfcacYhYaWUfUWhYfgh]WU
XY^Uhc5B7D &$$-"

!HfUhUaYbhcg#aYX]WUaYbhcgeiYdcggUadfcjcWUf
bzigYUg YgdYW]U`aYbhY cd]c]XYg Y ei]a]chYfUd]Ug
XYjYagYf]bXU[UXcg"
!9gh]`cXYj]XUUh]j]XUXYZg]WU h]dcYZfYeibW]U
XYU`]aYbhU~c ]b[Ygh~cXYg`]XcgY`ei]Xcg"
! 5gdYWhcg YacW]cbU]g  YWcba]Wcg Y gcW]U]g.
gYbh]aYbhcg dfYcWidUYg X]Z]Wi`XUXYgYWcba]WUg
eiYWUigYadfYcWidU~cci]adYUachfUhUaYbhc 
UWYggc Uc VUb\Y]fc Y aUbihYb~c XY \zV]hcg
XifUbhY \cfzf]c XY gYfj]c  baYfc XY VUb\Y]fcg
YaWUgU#acfUXcfYgYhW""
! C df]aY]fc WcbhUhc Wca ei]a]chYfUd]U Y
fUX]chYfUd]U  XYhYfa]bUbhY dUfU U ]XYbh]Z]WU~c
dfYWcWYXcgja]hcgUbhYW]dUhf]cgeiYdcXYagif[]f
bcgY[ibXcW]W`cYYgh~cfY`UW]cbUXcg{]bW]XbW]UY{
]bhYbg]XUXYXcgja]hcgUdfYgYbhUXcgbcdf]aY]fc"
! <UV]`]XUXY Xc XcYbhY Y XU ZUa`]U Ya `]XUf
WcaUgbzigYUgYja]hcg.]bZcfaUYgUXei]f]XUg 
gY[ifUbUdUfUUil]`]UfbchfUhUaYbhcYXYgYbjc`jYf
UYg"B~cg~cfUfcgcgWUgcgYaeiYcWi]XUXcfb~c
gidcfhUYghUf^ibhcbcacaYbhcYaeiYcdUW]YbhY
YghzbUigYUXccijca]hUbXc ceiYX]Z]Wi`hUU]bXU
aU]gcWcbjj]cWcaYghYg]bhcaU"
!=adUWhcgcW]U`YZUa]`]Uf.]bhYfZYfbW]UbUj]XUX]zf]U 
dfY^incg[YfUXcgdY`UgbzigYUgYja]hcgYgYiaUbY^c"9a
ai]hcgWUgcgcdUW]YbhYUVUbXcbUUcWidU~cdfcgg]cbU`
dcfb~cWcbgY[i]fWcbhfc`UfYghYXYgU[fUXzjY`g]bhcaU"
! 9ZYh]j]XUXY Xc hfUhUaYbhc Y gUh]gZU~c Wca
cfYgi`hUXc"
BcYlUaY Zg]WcXYjYagYfVigWUXcgg]bU]gWcac
XYg]XfUhU~c  U`hYfUYg XY VcWU Y cfcZUf]b[Y 
X]ghYbg~c UVXca]bU`  dfYgYbU XY aUggUg bU
hcdc[fUU UVXca]bU`  UgW]hY  g]bU]g XY `cWU`]nU~c
bYifc`[]WUYaYb]b[]gac5B7D &$$-"
DUfUUUjU`]U~cXYYlUaYgWcad`YaYbhUfYg]b]W]U]g 
g~c hY]g. \Yac[fUaU  if]bz`]gY Y fU]cg L FL XY
hfUl UjU`]U~cV]ceia]WUXUZib~c\Ydzh]WU fYbU`
YY`Yhf`]hcgWcacWz`W]c gX]cYdchzgg]c"BUgigdY]hU
XYcVghfi~cXYhfUhc[Ughfc]bhYgh]bU` FLg]ad`YgXY
UVXcaYYadcg]~ccfhcghzh]WUYgid]bUXYjYgYfZY]hc"
G]bU]gXYZU`bW]UfYbU`XYjYagYf]bjYgh][UXcgWca
i`hfUggcbc[fUUXYj]Ugif]bzf]Ug YgdYW]U`aYbhYbcg
dcfhUXcfYgXYhiacfYgd`j]Wcg5B7D &$$-"

INSTRUMENTOS DE AVALIAO
DE NUSEAS E VMITOS

C igc XY ]bghfiaYbhcg dUXfcb]nUXcg Wcac


ZYffUaYbhUgeiYg]ghYaUh]nYaUUjU`]U~cXYbzigYUg
Yja]hcg gYVYaXYgYbjc`j]XcgYjU`]XUXcg dcXYa
ZUW]`]hUf U UihcUjU`]U~c  U`a XY dcgg]V]`]hUf U
ib]Zcfa]nU~cbcgfY[]ghfcgYhfUhUaYbhcXYghYg"
v XY [fUbXY jU`]U iaU YgWU`U WUdUn XY UjU`]Uf c
]bW]c Y U ]bhYbg]XUXY Xcg g]bhcaUg  dcfa dciWcg
\cgd]hU]gUih]`]nUa"
BUHUVY`U'YbWcbhfUa!gYcg]bghfiaYbhcgX]gdcbjY]g
bU`]hYfUhifUdUfUUjU`]U~cXUgbzigYUgYja]hcg"

5D.zfYUdcghfYaU"BHG.bW`YcXchfUhcgc`]hzf]c"
:][ifU%"7cbg]XYfUYgUbUha]WUgUXUdhUXcXY<Yg_Yh\ &$$,"
Re v i s t a

B r a s i l e i r a

d e

C u i d a d o s

Pa l i a t i v o s

2 011;

(3)

S u p l e m e n t o

Re v i s t a

B r a s i l e i r a

d e

C u i d a d o s

Pa l i a t i v o s

2 011;

(3)

S u p l e m e n t o

)'((

:fej\ejf9iXj`c\`if[\E}lj\Xj\Md`kfj

:fej\ejf9iXj`c\`if[\E}lj\Xj\Md`kfj

SUPLEMENTO2
HUVY`U("7`Ugg]WU~cdUfUU[fUj]XUXYXUgbzigYUgYXcgja]hcg

=bghfiaYbhc #
FYZYfbW]U

8YgWf]~cY
5d`]WU~c

DfcdcghUY
G]bhcaUg

9j]XbW]U

JUbhU[Ybg

8YgjUbhU[Ybg

9CFH7E@E!7'$
#5UfcbgcbYhU`" 
%--'

'$ ]hYbg - ]hYbg


a`h]d`cgdcfYg!
WU`U@=_YfhYeiYg!
hYgg]ad`Yg"
5jU`]U~c EC@
dUfU WUgcg YgdY!
WWcgXYW|bWYf"
5ihcffY`Uhc"
HYadcdUfUdfY!
YbW\]aYbhc. , U
%,a]bihcg"

BzigYUg Y
ja]hcg

7cbghfihc Wca
UjU`]U~cjU`]XUXU
igUbXcWcffY`U~c
Wca giVYgWU`Ug 
YghUXc W`b]Wc Y
Yghz[]c XY hfUhU!
aYbhc"AcXYfUXU
UVcUWcbg]ghbW]U
]bhYfbU  U`ZU XY
7fcbVUW\1$ )&!
$ ,-" 6ca hYghY!
fYhYghY f1$ *'!
$ -%

:zW]` YbhYbX]!
aYbhc dY`cg
dUW]YbhYg

DUW]YbhYg gYa
Wi]XUXcg dU!
`]Uh]jcg bYWYg!
g]hUaXYU^iXU
dUfU dfYYbW\]!
aYbhc

9CFH7 E@E!7
%)!D5@ # ;fcYb!
jc`XYhU`" &$$*

AcX]Z]YX :ibW!
h]cbU`@]j]b[b!
XYl!9aYg]g!:@=9
# AUfh]b Yh U`" 
&$$'

A5G775bh]YaY!
g]gHcc`A5H
 A 5 G 7 7 !  H \ Y
Ai`h]bUh]cbU`
5ggcW]Uh]cb
cZ Giddcfh]jY
7UfY]b7UbWYf!
#Ac`Ugg]ch]g
YhU`" &$$+

H\Y 9Xacbhcb
Gmadhca5ggYg!
gaYbh GmghYa
9G5G # 6fiYfU
YhU`" %--%

 %) ]hYbg Wca


YgWc`\Ug YbhfY
bYaiadciWc
Yai]hc"
5ihcffY`Uhc"
 DUfU ih]`]nU~c
YaWi]XUXcgdU!
`]Uh]jcg"

BzigYUg

%,]hYbg +dcbhcg
J5G

5jU`]U~c
W`b]WU X]!
zf]U

,]hYbg

B z i g Y U g
Y ja]hcg
U [ i X c g  Y
hUfX]cg"
5WUXUW]W`c
XYei]a]c"

- g]bhcaUg UjU!
`]UXcg dcf 95J
XY %$ Wa" Ia
YgdUc dUfU g]b!
hcaU YgdYWZ]Wc
XcdUW]YbhY"
DUfU dUW]YbhYg
WcaW|bWYf"
5ihcffY`Uhc"
HYadcdUfUdfY!
YbW\]aYbhc. )
a]bihcg"

BzigYUg 
j a ] h c  Y
Y g Z c f c
dUfU jca]!
hUf"

G]bhcaU

d e

C u i d a d o s

;fUXU~c
%!DYfXUXYUdYh]hY gYaU`hYfU~cbcg\zV]hcgU`]aYbhUfYg/

BzigYU

&!5]b[Ygh~cfYXin]XUgYaXYg]XfUhU~cg][b]WUh]jU dYfXUXYdYgc ciXYgbihf]~c]bX]WU


cgi]XcgYbXcjYbcgcgYaaYbcgXY&(\cfUg/
'!=b[Ygh~cWU`f]WUci`ei]XU]bUXYeiUXU i]XcgYbXcjYbcgcg bihf]~cYbhYfU`cibihf]~c
dUfYbhYfU`hchU`]bX]WUXcZU]lUab]aUXY&(\cfUg/
(!7cbgYeibW]UgZUhU]g/
)!AcfhY"
Ja]hc

%!IaYd]gX]cYa&(\cfUg/
& ! 8Y Xc]g U W]bWc Yd]gX]cg Ya &( \cfUg  ]bX]WUbXc eiY U UXa]b]ghfU~c XY Z`i]Xcg
YbXcjYbcgcgXYjYgYf]b]W]UXUYaaYbcgXY&(\cfUg/
' ! GY]g ci aU]g Yd]gX]cg Ya &( \cfUg  ]bX]WUbXc `ei]Xcg YbXcjYbcgcg ci bihf]~c

:UW]`]XUXY bU
]bhYfdfYhU~c
XcgXUXcg

dUfYbhYfU`ab]aUXY&(\cfUg/
(!7cbgYeibW]UgZUhU]g/
)!AcfhY"
Bc6fUg]` iaXcg]bghfiaYbhcgaU]gih]`]nUXcgH\Y9XacbhcbGmadhca5ggYggaYbhGmghYa9G5G WcbZcfaYcg
YgdYW]U`]ghUgXYghYWcbgYbgc aYgacU]bXUb~cYghUbXcjU`]XUXUdUfUcdcfhi[igZU`UXcbc6fUg]`5B7D &$$-"

6cU Wcbg]g!
h b W ] U  ] b h Y f b U
7fcbVUW\gU`d\U
$ ++$ +,

5`hU Wcbg]ghbW]U
]bhYfbU 5`ZU XY
7fcbVUW\ $ ++!
$ ,&

AcXYfUXU WcffY!
`U~cdUfUbzigYU
 f1$ *&" HYghY!
fYhYghY Wca ZcfhY
WcffY`U~cUdg&
X]Ugf1$ ,*"

EiYghYg UjU!
`]Ua c ]adUW!
hc XY bzigYUg
Y ja]hcg bU
j]XUX]zf]U

8 ] Z ] W i ` X U X Y
Ya X]gh]b[i]f
dYfXU XU Zib!
~c dcf cihfUg
WUigUg

7 ` U f U  Z z W ] `
Ud`]WU~c W`!
b]WU  ZUW]`]hU
X]gWigg~c gc!
VfY U YldYf]!
bW]U XY bzi!
gYUg Y ja]hcg
YbhfYcW`b]Wc
Y c dUW]YbhY 
dchYbW]U`]nU
dfcWYggcg XY!
W]gf]cgXYhfU!
hUaYbhc"

DcXYgYfigUXc
dcfdfcWifU~c
ciWcaUil`]c
UcdUW]YbhYbc
dfYYbW\]aYb!
hc

Ai]hcgdUW]Yb!
hYg h]jYfUa X]!
Z]Wi`XUXY Ya
ih]`]nz!`U gcn]!
b\cg"

5 HUVY`U ( Wcbha c 7UbWYf H\YfUdm 9jU`iUh]cb Dfc[fUa eiY ih]`]nU W]bWc Wf]hf]cg XY W`Ugg]WU~c dUfU U
[fUj]XUXYXUgbzigYUgYXcgja]hcgih]`]nUXUgdUfUdUW]YbhYgYa[YfU` ]bXYdYbXYbhYXYgYfYaXYWi]XUXcg
dU`]Uh]jcgcib~c7H759 &$$*"
B r a s i l e i r a

0

SUPLEMENTO 2

HUVY`U'"8YgWf]~cXcg]bghfiaYbhcgXYUjU`]U~cXYbzigYUgYja]hcg"

Re v i s t a

)'((

Pa l i a t i v o s

2 011;

(3)

S u p l e m e n t o

:][ifU&"9gWU`UXYUjU`]U~cXYg]bhcaUgXY9Xacbhcb9G5G"
2

Re v i s t a

B r a s i l e i r a

d e

C u i d a d o s

Pa l i a t i v o s

2 011;

(3)

S u p l e m e n t o

('

)'((

:fej\ejf9iXj`c\`if[\E}lj\Xj\Md`kfj

:fej\ejf9iXj`c\`if[\E}lj\Xj\Md`kfj

SUPLEMENTO2

)'((

((

SUPLEMENTO 2

9G5G  Wcadcghc dcf bcjY g]bhcaUg Zg]Wcg Y


dg]Wc`[]WcgYbWcbhfUXcgYadUW]YbhYgWcaW|bWYfY
UjU`]UXcYa[fUXiU~ceiYjUf]UXY$U%$:]["&"
G~cWcbhYad`UXcgcgg]bhcaUgaU]g]adcfhUbhYgdUfU
cgdUW]YbhYg ]bW`i]bXcbzigYUgYja]hcg"9bhfYhUbhc 
AcbhY]fc&$$-gi[YfYUUad`]U~cXYYghiXcggcVfY
YghU YgWU`U  XYghUWUbXc U`[iaUg `]a]hUYg Wcac

X]Wi`XUXYbcdfYYbW\]aYbhcdUfUdUW]YbhYghYfa]bU]g 
Wca dfcV`YaUg Wc[b]h]jcg ci Zg]Wcg  X]Z]Wi`XUXYg
eiUbhcUhYfa]bc`c[]UgYZU`hUXYU`[ibgg]bhcaUg"
9a &$$,  c 7cbgY`\c FY[]cbU` XY AYX]W]bU Xc
9ghUXc XY G~c DUi`c dfcdg eiUhfc YhUdUg dUfU
UjU`]U~cXUgbzigYUgYja]hcg WcbZcfaYU:][ifU'
7\]VU &$$&"

8]U[bgh]WcXYBzigYUg
5jU`]U~c]b]W]U`.

BC

DYf[ibhUf.JcWgYbhYbzigYUg3

DfYgYbUXYBzigYUg

BzigYUgYJa]hcg

9G5G

G=A

=bhYbg]XUXYigUfYgWU`Ubiaf]WUciYgWU`U
j]giU`Ubz`c[U

G]a

9hUdU%

DfcdcghUg
hYfUdih]WUg

DYf[ibhUf.JcWgUVYceiYUdfcjcWU3
EiUbXc]b]W]ci37caeiYZfYebW]UcWcffY3

5jU`]U~cXYgY[aYbhc
9ZYh]j]XUXY
AY`\cfUXcg]bX]WUXcfYg
XU9G5G

=bW]c XifU~cYZfYeibW]UXYYd]gX]cg XY


\zV]hc]bhYgh]bU` bzigYUYja]hcg U`aXU
eiUbh]XUXYYeiU`]XUXYXcgja]hcg

G=A
9ZYh]jc

5jU`]U~cXUgWUigUgXUgbzigYUg
!5gdYWhcgYacW]cbU]g/
!5gdYWhcgg]cdUhc`[]WcYaYX]WUaYbhcgcg/
!CVghfi~c]bhYgh]bU`3
!5XYg~cUchfUhUaYbhc/
!7fYbUgYWcb\YW]aYbhcgUfYgdY]hcXUgbzigYUg/
!7cadfcaYh]aYbhcXYg]ghYaUbYfjcgcWYbhfU`3

BC
9ZYh]jc

:UhcfYgXYaY`\cfUYXYd]cfU
8]U[bgh]WcXYJa]hcg
<]ghf]UXcdUW]YbhYYgiUdfYgWf]~cUhiU` 
dUfUXYhYfa]bUfdcggjY]gWUigUgXYbzigYU

9hUdU&

5jU`]U~c]b]W]U`.

BC

DYf[ibhUf.JcWhYah]Xcja]hcg3

DfYgYbUXYJa]hcg
9G5G

G=A
9lW`i]fcVghfi~c]bhYgh]bU` 
WcadfcaYh]aYbhcXYg]ghYaUbYfjcgcWYbhfU`
Y#ciXYcihfcgaYWUb]gacg

9hUdU'

DYf[ibhUf
<zeiUbhchYadcjYaUdfYgYbhUbXcja]hcg3
JcWgUVYceiYcdfcjcWU3
7caeiYZfYebW]UcWcffY3EiU`cUgdYWhc3
EiUbhUgjYnYgdcfX]U3EiU`UeiUbh]XUXY3

DfcdcghUg
hYfUdih]WUg
5jU`]U~c`UVcfUhcf]U`XYY`Yhf`]hcg Zib~c
fYbU`Y\Ydzh]WU"GYbYWYggzf]c igUfcihfcg
dUf|aYhfcgdYfh]bYbhYg

9hUdU(

5jU`]U~cXUgWUigUgXcgja]hcg

:][ifU'"9hUdUgXY5jU`]U~cXYBzigYUgYJa]hcg7\]VU &$$&"
BcgWUgcgYaeiYcdUW]YbhYgiVaYh]Xc{ei]a]chYfUd]U g~cih]`]nUXUgYgWU`UgYgdYWWUg WcacU7caacb
HYfa]bc`c[m7f]hYf]UZcf5XjYfgY9jYbhg7H759jYfg~c==hfUXin]XUdUfUU`b[iUdcfhi[iYgU"
7cbg]XYfUYgilc[fUaUXYUjU`]U~c
7ca VUgY bU Ubz`]gY XU `]hYfUhifU Y cd]b]~c
XY YgdYW]U`]ghUg dUfh]W]dUbhYg XYghY WcbgYbgc 
Y`UVcfci!gY iaU dfcdcghU XY UjU`]U~c X]j]X]XU
Ya UjU`]U~c ]b]W]U` ]XYbh]Z]WU~c XU dfYgYbU
XUgbzigYUgYja]hcgYUjU`]UYgXYgY[i]aYbhc
Re v i s t a

B r a s i l e i r a

d e

C u i d a d o s

]XYbh]Z]WU~c XUg WUigUg XY bzigYUg Y ja]hcg 


XYZ]b]~c XUg dfcdcghUg hYfUdih]WUg Y UjU`]U~c
XcfYgi`hUXcXUhYfUd]U"8YggUUjU`]U~c]b]W]U`
Y XY gY[i]aYbhc ZUn dUfhY c ]bghfiaYbhc 9G5G"
C Z`ilc[fUaU XY UjU`]U~c Yghz UdfYgYbhUXc U
gY[i]f:]["("

Pa l i a t i v o s

2 011;

(3)

S u p l e m e n t o

!5gdYWhcgYacW]cbU]gja]hcgUbhYW]dUhf]cg3/
!5gdYWhcgg]cdUhc`[]WcgYaYX]WUaYbhcgcg/
!CVghfi~c]bhYgh]bU`3
!5XYg~cUchfUhUaYbhc/
!7fYbUgYWcb\YW]aYbhcgUfYgdY]hcXcgja]hcg/
!7cadfcaYh]aYbhcXYg]ghYaUbYfjcgcWYbhfU`3
!9l]ghYaZUhcfYgXYgYbWUXYUbhYgciU[fUjUbhYg/

5jU`]U~cXYgY[aYbhc
9ZYh]j]XUXY
AY`\cfUXcg]bX]WUXcfYg
XU9G5G

G=A
9ZYh]jc

BC
9ZYh]jc

:][ifU(":`ilc[fUaUgXYUjU`]U~cXYbzigYUgYja]hcg"
2

Re v i s t a

B r a s i l e i r a

d e

C u i d a d o s

Pa l i a t i v o s

2 011;

(3)

S u p l e m e n t o

()

)'((

:fej\ejf9iXj`c\`if[\E}lj\Xj\Md`kfj

:fej\ejf9iXj`c\`if[\E}lj\Xj\Md`kfj

SUPLEMENTO2
E GRADAO EM PEDIATRIA
BzigYUg Y ja]hcg Ya dUW]YbhYg dYX]zhf]Wcg
dcXYa hYf X]jYfgUg WUigUg  hU]g Wcac c igc XY
aYX]WUaYbhcg Ubh]bYcd`zg]Wcg  Ubh]a]WfcV]Ubcg 
c d ] c ] X Y g   ] b Z Y W Y g  g ] g h a ] W U g  U ` h Y f U Y g
aYhUV`]WUg Wcac \]dYfWU`WYa]U Y \]dcbUhfYa]U 
]bgiZ]W]bW]U UXfYbcWcfh]WU`  UiaYbhc XU dfYgg~c
]bhfUWfUb]UbU  ]ff]hUYg Y#ci i`WYfUYg [zghf]WUg 
Wcbgh]dU~c  cVghfi~c ]bhYgh]bU`  U`hYfUYg Xc
hfUhc[Ughf]bhYgh]bU`WcacfYZ`ilc[UghfcYgcZz[]WcY
YghUgY[zghf]WU U`aXYU`hYfUYgdg]Wc`[]WUgWcac
Ubg]YXUXY Y YghfYggY YacW]cbU` ?UfkUW_]  &$$+/
9dY`aUbYhU`" &$%$/GUbhiWW]AUW_ &$$+"
9l]ghYahUaVabzigYUgYja]hcgUbhYW]dUhf]cg 
eiY dcXYa cWcffYf ]bXYdYbXYbhYaYbhY XY ZUhcfYg
WUigU]g YaeiU`eiYfWf]UbUciUXc`YgWYbhYeiYhYb\U
h]XcdfYj]UaYbhYbzigYUYja]hcgYaWcbhfc`YYZYh]jc
KUhhg;iUf]bc &$%$"
9a Wi]XUXcg dU`]Uh]jcg dYX]zhf]Wcg  ai]hcg
dUW]YbhYg j]jYbW]Ua gcZf]aYbhc UWYbhiUXc XYj]Xc
UbzigYUgYja]hcg ceiYdcXYWUigUfXYgWcbZcfhc
]adcfhUbhY Wcac Xcf  XYg]XfUhU~c  gc`ic  Un]U Y
UbcfYl]UKUhhg;iUf]bc &$%$/GUbhiWW]AUW_ 
&$$+"5UhYb~cYcaUbY^cUXYeiUXcXYghYgg]bhcaUg
g~c ZibXUaYbhU]g dUfU dfcdcfW]cbUf WcbZcfhc Y
eiU`]XUXYXYj]XU{gWf]UbUgciUXc`YgWYbhYgYgiUg
ZUa`]UgXifUbhYhcXUgUgZUgYgXchfUhUaYbhc"
DUfUeiYgYcVhYb\UgiWYggcbcaUbY^cYWcbhfc`Y
XYbzigYUgYja]hcgbUdcdi`U~cdYX]zhf]WU ZUn!gY
bYWYggzf]c iaU UjU`]U~c Wcad`YhU Wcbg]XYfUbXc!
gY Ug dcggjY]g WUigUg Ugg]a Wcac c fY`Uhc XUg
Wf]UbUg ci UXc`YgWYbhYg Y gYig Wi]XUXcfYg" 5
\]ghf]UdfY[fYggUXYhU`\UXUXUbzigYUYja]hc U
ZfYeibW]UXYghYgg]bhcaUg dYfcXcgYaeiYYgh~c
aU]gdfYgYbhYg XYgWf]~cY]bhYbg]XUXYXcgaYgacg 
Wcac eiUbh]XUXY Y WUfUWhYfgh]WUg Xc WcbhYXc
YldY`]Xc \cfzf]cgXcgYd]gX]cg ZUhcfYgUggcW]UXcg
Y#ci dfYX]gdcbYbhYg g~c XY YlhfYaU ]adcfh|bW]U
dUfU U YZ]WzW]U Xc hfUhUaYbhc U gYf YgWc`\]Xc
GUbhiWW]AUW_ &$$+"G~chUaVa]adcfhUbhYg
cg ZUhcfYg eiY XYgYbWUXY]Ua YghYg g]bhcaUg 
ZUhcfYgXYU`j]cYXYd]cfU dfYgYbUWcbWca]hUbhY
Xcg Xc]g g]bhcaUg ci XY gcaYbhY ia" 8YjY!gY
fYU`]nUf ia YlUaY Zg]Wc Wcad`Yhc UhYbhUf dUfU
hif[cfXUdY`Y WUfUWhYfgh]WUgXUgaiWcgUg aUggUg
UVXca]bU]gdU`dzjY]g UigWi`hUUVXca]bU` dfYgYbU
XYZcbhUbY`UgUVUi`UXUgciXYdf]a]XUg U`aXYgY
eiYgh]cbUfY]bjYgh][UfU]b[Ygh~ccfU`YgYbgU~cXY
gUW]YXUXY \]XfUhU~c dfYgYbUXYXcfUVXca]bU` 
Wcbgh]dU~c  X]UffY]U  fYZ`ilc [UghfcYgcZz[]Wc 
WYZU`Y]U X]ghfV]cgbYifc`[]Wcg dcggjY]gWUigUgXY
\]dYfhYbg~c]bhfUWfUb]UbU aYX]WUaYbhcgYZUhcfYg
dg]Wc`[]WcgWcacUbg]YXUXYYXYdfYgg~cKUhhg
;iUf]bc &$%$/GUbhiWW]AUW_ &$$+"
5  U j U ` ] U ~ c  W c a d ` Y a Y b h U f  d c f  Y l U a Y g
`UVcfUhcf]U]g Y XY ]aU[Ya XYdYbXYa XU gigdY]hU
W`b]WUYdfYW]gUagYfXYhYfa]bUXcgWUgcUWUgc"5`a
XUXYgWf]~cXUbzigYUYXcja]hc Yl]ghYaYgWU`Ug
eiY aYbgifUa U ]bhYbg]XUXY XYghYg g]bhcaUg 
Wcbhf]Vi]bXchUaVadUfUX]fYW]cbUfUg]bhYfjYbYg
aYX]WUaYbhcgUgYb~caYX]WUaYbhcgUg"
Ja]hc  ZUW]`aYbhY eiUbh]Z]WUXc UhfUjg
XU ZfYeibW]U XY Yd]gX]cg" BzigYU  XY X]ZW]`
UjU`]U~c Ya Wf]UbUg  Ya dUfh]Wi`Uf bUeiY`Ug
]bWUdUnYgXYUihcffY`Uhcg"
C7caacbHYfa]bc`c[m7f]hYf]UZcf5XjYfgY9jYbhg
Zc] XYgYbjc`j]Xc dY`c BUh]cbU` 7UbWYf =bgh]hihY
B7= bcfhY!UaYf]WUbc dUfU gYfj]f XY fYZYfYbW]U` 
Y Wcbha hUVY`U XY [fUXU~c XY ]bhYbg]XUXY
Xcg X]jYfgcg YjYbhcg UXjYfgcg fY`UW]cbUXcg Uc
hfUhUaYbhc Ubh]bYcd`zg]Wc" DUfU U UjU`]U~c XY
bzigYU Y ja]hc  gi[YfY!gY U ih]`]nU~c XYggU
W`Ugg]Z]WU~c7H759 &$$*dcfZUW]`]hUfUfY`U~c
UjU`]U~c#]bhYfjYb~cXYghYgg]bhcaUgbUdcdi`U~c

B r a s i l e i r a

(*

SUPLEMENTO 2

AVALIAO

Re v i s t a

)'((

d e

C u i d a d o s

TRATAMENTO

MEDICAMENTOSO
5g aYX]WUYg ih]`]nUXUg bc Wcbhfc`Y XY bzigYUg
Y ja]hcg dcXYa gYf X]j]X]XUg Ya hfg [fUbXYg
WUhY[cf]Ug.cgUbh]Yah]Wcg cgdf!W]bh]WcgYcihfUg
aYX]WUYgih]`]nUXUgYag]hiUYgYgdYW]U]gHUV")"
8Yj]Xc{X]jYfg]XUXYXUZ]g]cdUhc[Yb]UXYbzigYUg
Y ja]hcg  U ih]`]nU~c XUg aYX]WUYg XYjYfz gYf
ZY]hU Ya WUXU g]hiU~c YgdYWZ]WU" 8YghU ZcfaU 
YgeiYaUgXYaYX]WUaYbhcgfYWcaYbXUXcgbUdg!
ei]a]chYfUd]Ug~cX]gh]bhcgXUeiY`Ygih]`]nUXcgbU
cVghfi~c]bhYgh]bU`"
Cg U[YbhYg Ubh]Yah]Wcg g~c ZzfaUWcg eiY
df]aUf]UaYbhY UhiUa bc g]ghYaU bYfjcgc WYbhfU` 
Wcac cg Ubh]!\]ghUab]Wcg  cg Ubh]Wc`]bf[]Wcg  cg
Ubh]XcdUa]bf[]Wcg  cg UbhU[cb]ghUg )!<H' Y cg
UbhU[cb]ghUgXUbYifcW]b]bU%B?%"

dYX]zhf]WU Y dY`U ZUW]`]XUXY XY aUbigY]c dY`cg


X]ZYfYbhYgdfcZ]gg]cbU]gXUgUXY"

MEDIDAS

DIETTICAS
5g aYX]XUg X]Yhh]WUg XYjYa gYf UXYeiUXUg {g
bYWYgg]XUXYgXc]bX]jXic giUgdfYZYfbW]UgYgYig
\zV]hcg U`]aYbhUfYg 6YbUffcn Yh U`"  &$$- Y Uc
gYfYa igUXUg ^ibhUaYbhY Wca cg aYX]WUaYbhcg
Ubh]Yah]WcgdcXYaU^iXUfUfYXin]fUZfYeibW]UY
XcgYXcgaYgacgF\cXYgAW8Ub]Y` &$$%"
5`[iaUg aYX]XUg g]ad`Yg dcXYa Uil]`]Uf bc
Wcbhfc`YXUgbzigYUgYja]hcg WcaccZfUW]cbUaYbhc
XUX]YhUYadYeiYbUgfYZY]YgYa]bhYfjU`cgaYbcfYg
Ib5h] &$$-/=B75 &$$%/F\cXYgAW8Ub]Y` &$$%/
6YbUffcnYhU`" &$$-/AiffUm &$$-/7`]bY &$$*/FD7D 
&$$&/AUWa]``UbYhU`" &$$(/=B75 &$$$/<Uff]g &$%$/
77C &$%$  U fYU`]nU~c XUg fYZY]Yg Ya UaV]YbhY
hfUbei]`c Y UfY^UXc Ib5h]  &$$-/ AiffUm  &$$- 
aUbihYb~cXY\cfzf]cgYghUVY`YW]XcgdUfUUgfYZY]Yg
Ib5h]  &$$-  U cZYfhU XY dYeiYbUg eiUbh]XUXYg XY
WUfVc]XfUhcgF\cXYgAW8Ub]Y` &$$%YUcZYfhUXY
U`]aYbhcgeiYgY^UaXUdfYZYfbW]UXcdUW]YbhYIb5h] 
&$$-/AiffUm &$$-/AUWa]``UbYhU`" &$$("
5`aX]ggc ]adcfhUbhY.Yj]hUfeiYcdUW]YbhY
XY]hY!gY`c[cUdgUgfYZY]Yg aUbhYbXcgiUWUVYU
Y`YjUXU dcf Uh iaU U XiUg \cfUg Udg U ]b[Ygh~c
XY U`]aYbhcg 7`]bY  &$$*/ AUWa]``Ub Yh U`"  &$$(/
FD7D  &$$&/ 77C  &$%$/ Yj]hUf dfYdUfUYg Ya
hYadYfUhifUg YlhfYaUg  dfYZYf]bXc dfYdUfUYg U
hYadYfUhifU UaV]YbhY ci U`]aYbhcg Zf]cg Ib5h] 
&$$-/6YbUffcnYhU`" &$$-/=B75 &$$$/AUWa]``Ub
YhU`" &$$(/Yj]hUfeiYcdUW]YbhYZ]eiYdfl]ac{
Wcn]b\UbU\cfUXcdfYdUfcXUfYZY]~cAUWa]``Ub
Yh U`"  &$$(  ]adYX]bXc Ugg]a eiY cg W\Y]fcg
Xcg U`]aYbhcg XifUbhY U WcW~c UWYbhiYa Ug
bzigYUg/ Yj]hUf Zf]hifUg  U`]aYbhcg [cfXifcgcg 
WcbX]aYbhUXcg  gU`[UXcg  zW]Xcg  UiWUfUXcg Y
WcacXcfZcfhYIb5h] &$$-/=B75 &$$%/F\cXYg
AW8Ub]Y` &$$%/6YbUffcnYhU`" &$$-/<Uff]g &$%$/
AUWa]``Ub Yh U`"  &$$(/ 7`]bY  &$$*/ FD7D  &$$&/
Yj]hUf U`]aYbhcg UnYXcg  Wcac `]a~c  d]W`Yg ci
VU`UgXifUgF\cXYgAW8Ub]Y` &$$%/77C &$%$ 
Ugg]aWcacUcZYfhUXY`ei]XcgXifUbhY{gfYZY]Yg
6YbUffcn Yh U`"  &$$-/ 77C  &$%$" Bc YbhUbhc 
XYjY!gYdf]cf]nUfU]b[Ygh~cXYc]hcUXYnWcdcgXY
`ei]XcgYbhfYUgfYZY]YgdUfUYj]hUfXYg]XfUhU~c"
9ghU aUbcVfU a]b]a]nU U dfYgg~c bc YghaU[c
fYXin]bXcUcWcffbW]UXYfYZ`ilc7`]bY &$$*/FD7D 
&$$&/77C &$%$"8YbhfYYghYg`ei]Xcg VcUgcdYg
g~c cg `ei]Xcg W`Ufcg  Wcac giWcg  W\zg  WU`Xcg 
[Y`Uh]bUg  [Yb[]VfY Y `UgWUg XY [Y`cg 7`]bY  &$$*/
AUWa]``Ub Yh U`"  &$$( Y `]a]hUf c igc XY `ei]Xcg
WUZY]bUXcg ]bW`i]bXcfYZf][YfUbhYgUVUgYXYWc`Ug 
WUZYW\zg77C &$%$"
FYZY]YgWcaU`hchYcfdfchY]Wc WcadUfUXUg{g
fYZY]Ygf]WUgYaWUfVc]XfUhcgY[cfXifU h]jYfUa
YZY]hc dcg]h]jc Ya fYXin]f bzigYUg Ya dUW]YbhYg
YadUW]YbhYUXi`hcgAUlYhU`" &$$-/@Yj]bYYhU`" 
&$$,"IaUgXUg^igh]Z]WUh]jUgXYhU`VYbYZW]cgYf]UU
fYXi~cXUgX]gf]ha]Ug[zghf]WUgAUlYhU`" &$$-"
9a WUgc XY ja]hcg Wcbhbicg   UWcbgY`\zjY`
`]a]hUf eiU`eiYf Wca]XU ci VYV]XU Uh c ja]hc
WYggUf  Udg U[iUfXUf dcf '$ U *$ a]bihcg Y Ybh~c
]b]W]UfUU`]aYbhU~cYadYeiYbUeiUbh]XUXY[c`Yg
XY`ei]XcgW`Ufcg77C &$%$"
5`a X]ggc  cf]YbhUf Y YXiWUf c dUW]YbhY Y gYi
Wi]XUXcfai]hc]adcfhUbhYdUfUcgiWYggcbcaUbY^c
XYbzigYUgYja]hcg77C &$%$"
8Y UWcfXc Wca fYWcaYbXU~c Xc =bgh]hihc
BUW]cbU` Xc 7|bWYf =B75  &$$$ XYjY!gY Yj]hUf
cZYfYWYf U`]aYbhcg gY U bzigYU Zcf XYj]Xc { YghUgY
[zghf]WU" BYghYg WUgcg Y bUeiY`Yg XYWcffYbhYg XY
cVghfi~cdfcl]aU` U`]hYfUhifU]bX]WUcigcXYhYfUd]U
bihf]W]cbU`j]UYbhYfU`7\Yfbm &$$("

Pa l i a t i v o s

2 011;

(3)

S u p l e m e n t o

Cgdf!W]bh]WcghaU~cdfYXca]bUbhYaYbhYdYf]Zf]WU 
WcaccgU[cb]ghUg)!<H( U[YbhYgUbh]XcdUa]bf[]Wcg
dYf]Zf]WcgYcgUbz`c[cgXUgcaUhcghUh]bU"
8 Y b h f Y  c g  a Y X ] W U a Y b h c g  i h ] ` ] n U X c g  Y a
g]hiUYg YgdYW]U]g   dcggjY` Y`YbWUf U ih]`]nU~c
XY VYbncX]UnYdb]Wcg bc hfUhUaYbhc XU bzigYU
UbhYW]dUhf]U  cg [`]WcWcfh]Wc]XYg bU dfYjYb~c XU
bzigYUYja]hcU[iXUdgei]a]chYfUd]UYUdcggjY`
ih]`]nU~cXcgU[YbhYgWUbUV]b]XYg"
C`UbnUd]bU  iaU aYX]WU~c Ubh]dg]Wh]WU eiY
dcXY gYf ih]`]nUXU ^ibhc Wca ]b]V]XcfYg )!<H' Y
Wcfh]Wc]XYgWcaccV^Yh]jcXYaY`\cfUfcgfYgi`hUXcg
XUdfc`Ul]UXUBJEHhUfX]UYbgU]cW`b]WcZUgY===
HUb Yh U`"  &$$-" HUaVa dcXY gYf ih]`]nUXU Wcac
aYX]WU~cdUfUcWcbhfc`YXUBJEHfYZfUhzf]UfY`Uhcg
XYWUgcgGf]jUghUjUYhU`" &$$'"

HUVY`U)"7UfUWhYfgh]WUgXcgU[YbhYgih]`]nUXcgbcWcbhfc`YXYbzigYUgYja]hcg"
7`UggY

AYWUb]gac

9lYad`cg

=bX]WUYg

5bh]Yah]Wcg

5bh]!\]ghUab]Wc

AYW`]n]bU

8cYbUXcacj]aYbhc 
XcYbUgXccij]Xc]bhYfbc

5bh]Wc`]bf[]Wc

9gWcdc`Ua]bU

8cYbUXcacj]aYbhc 
XcYbUgXccij]Xc]bhYfbc

5bh]XcdUa]bf[]Wc

DfcW`cfdYfUn]bU
8fcadYf]Xc`

aYgY]bXin]XUdcf
aYX]WUaYbhcg hcl]W]bUg
ciaYhUV`]WU

5bhU[cb]ghU)<H'

CbXUbgYhfcb ;fUb]gYhfcb 
8c`UgYhfcb Hfcd]gYhfcb 
DU`cbcgYhfcb

aYgY]bXin]XU
dcfei]a]chYfUd]U 
fUX]chYfUd]U aYgYdg!
cdYfUhf]U

5bhU[cb]ghUB?%

5dfYd]hUbhY

aYgY]bXin]XUdcf
ei]a]chYfUd]U

5[cb]ghU)!<H(

7]gUdf]XU

;UghfcdUfYg]U dgYiXc!
cVghfi~c]bhYgh]bU`

5[cb]ghU)!<H(Y
Ubh]XcdUa]bf[]Wc

AYhcW`cdfUa]XU

;UghfcdUfYg]U

5bh]XcdUa]bf[]Wc
dYf]Zf]Wc

8cadYf]XcbU

;UghfcdUfYg]U

5bz`c[cXYgcaUhcghUh]bU

CWhfYchXYc

DgYiXc!cVghfi~c
]bhYgh]bU`

6YbncX]UnYdb]Wcg

@cfUnYdUa

BzigYUUbhYW]dUhf]U

;`]WcWcfh]Wc]XYg

8YlUaYhUgcbU
AYh]`dfYXb]gc`cbU

Dg!ei]a]chYfUd]U

DfcW]bh]Wcg

G]hiUYg
YgdYW]U]g

7UbUV]b]XYg

Dg!ei]a]chYfUd]U

8cgYgYj]UgXYUXa]b]ghfU~c
DUfUcWcbhfc`YUXYeiUXcXYbzigYUgYja]hcg 
XYjY!gYcVgYfjUfUXcgY cg]bhYfjU`cgY gcVfYhiXc 
Uj]UXYUXa]b]ghfU~cXUgaYX]WUYgHUV"* dc]g
Yaai]hcgdUW]YbhYgUih]`]nU~cXYaYX]WUYgdcf
2

Re v i s t a

B r a s i l e i r a

d e

C u i d a d o s

j]U cfU` YbWcbhfU!gY dfY^iX]WUXU Ya j]fhiXY Xcg


g]bhcaUg  g]hiUYg XY dg!cdYfUhf]c  eiYXU Xc
bjY`XYWcbgW]bW]UcicVghfi~c]bhYgh]bU`"
CgUbhU[cb]ghUg)!<H'eiUbXcih]`]nUXcgYaXcgYg
Yei]jU`YbhYghaYWzW]UgYaY`\UbhY?f]gYhU`" &$$*"
Pa l i a t i v o s

2 011;

(3)

S u p l e m e n t o

(+

)'((

:fej\ejf9iXj`c\`if[\E}lj\Xj\Md`kfj

:fej\ejf9iXj`c\`if[\E}lj\Xj\Md`kfj

SUPLEMENTO2

(,

SUPLEMENTO 2

HUVY`U*"J]UgXYUXa]b]ghfU~cYXcgYgXYU`[ibgU[YbhYgih]`]nUXcgbcWcbhfc`YXYbzigYUgYja]hcg"
AYX]WUaYbhc#J]U

CfU`

GiVWih|bYU

CbXUbgYhfcb

&(a[

,a[

;fUb]gYhfcb

&a[

%a[

5dfYd]hUbhY

$ &)a[
%&)a[

AYhcW`cdfUa]XU

($!%&$a[

CWhfYchXYc

%)$!%)$$[

8YlUaYhUgcbU

ADVERSOS
CgZzfaUWcgih]`]nUXcgbcWcbhfc`YXYbzigYUgYja]hcg
dcXYaUdfYgYbhUfYZY]hcgUXjYfgcg Ydcf]ggc eiUbXcdcggjY` 
XYjYagYfhcaUXUgaYX]XUgdfYjYbh]jUg6cmX &$$,"
DfcaYhUn]bU dfcW`cfdYfUn]bUYXfcadYf]Xc`dcXYa
WUigUfgYXU~c jYfh][YbgYg]bhcaUgYlhfUd]fUa]XU]g"
Cg]b]V]XcfYg)!<H'WUigUaWcaY`YjUXUZfYeibW]U
Wcbgh]dU~c]bhYgh]bU` YWcaaYbcfZfYeibW]UWYZU`Y]U
YY`YjU~cXYYbn]aUg\Ydzh]WUg"
AYhcW`cdfUa]XUdcXYcWUg]cbUfgYXU~c \]dchYbg~c 
hcbhifUg Y U`hYfUYg YbXWf]bUg [U`UWhcff]U 
UaYbcff]U []bYWcaUgh]U"
5dfYd]hUbhY hYa Wca YZY]hcg UXjYfgcg WYZU`Y]U 
ZUX][U jYfh][YbgYY`YjU~cXUgYbn]aUg\Ydzh]WUg"
;`]WcWcfh]Wc]XYg dcXYa hfUnYf hcXcg cg g]bhcaUg
fY`UW]cbUXcgUcYlWYggcXYWcfh]Wc]XYg/UXYlUaYhUgcbU
dcXYWUigUfdfif]XcUbU`YjU[]bU` Yig\ZUW]U`eiUbXc
UXa]b]ghfUXUYa]bZig~cfzd]XU"

NUSEA E VMITOS PS-QUIMIOTERAPIA
CgU[YbhYgei]a]chYfzd]Wcgih]`]nUXcgbUhYfUd]U
cbWc`[]WU UdfYgYbhUa Wcac df]bW]dU]g hcl]W]XUXYg
bzigYUgYja]hcg"
5aYgYU[iXU[YfU`aYbhYVYaWcbhfc`UXUWca
WcaV]bU~c XY aYX]WUYg  Wi^U YgWc`\U XYdYbXY
XU]bhYbg]XUXYYgdYfUXU XYUWcfXcWcacU[YbhYci
WcaV]bU~cXYXfc[UgXUei]a]chYfUd]U"
;YfU`aYbhY bzigYUg Y ja]hcg hUfX]cg ha  Ugg]a
Wcac cg fYZfUhzf]cg  Wcbhfc`Y aU]g X]ZW]`" 5 aY`\cf
UVcfXU[YaUih]`]nU~cXYaYX]XUgdfc`zh]WUg"
Cgdf]bW]dU]gZUhcfYgXYf]gWcdUfUcXYgYbjc`j]aYbhc
XY bzigYUg Y ja]hcg dg!ei]a]chYfUd]U  U`a XUg
WUfUWhYfgh]WUgXcgU[YbhYgei]a]chYfzd]Wcg g~c.
!:UhcfYgaU]cfYg.gYlcZYa]b]bc ]XUXYaYbcfeiY)$Ubcg 
\]ghf]UXYVU]lcWcbgiacXYz`Wcc` \]ghf]UXYbzigYUgY
ja]hcgYahfUhUaYbhcgei]a]chYfzd]Wcgdfj]cg"
!:UhcfYgaYbcfYg.\]ghf]UXYXcYbUXcacj]aYbhc 
bzigYUgYja]hcgXifUbhY[fUj]XYndfj]UBUjUf] &$$-"

(!&$a[
HUVY`U +" DchYbW]U` YaYhc[b]Wc Xcg U[YbhYg
Ubh]bYcd`zg]Wcgih]`]nUXcgdcfj]U]bhfUjYbcgU"
;fUiXY
YaYhc[Yb]W]XUXY

d e

C u i d a d o s

Pa l i a t i v o s

5[YbhY

5`hc
2-$

7Ufaigh]bU
7]W`cZcgZUa]XU2% )[#a&
7]gd`Uh]bU
8UWUfVUn]bU
9ghfYdhcnchcW]bU
AYW`cfYhUa]bU

AcXYfUXc
'$!-$

5`YahiniaUVY
5nUW]h]X]bU
6YbXUaigh]bU
7UfVcd`Uh]bU
7]W`cZcgZUa]XU0% )[#a&
7]hUfUV]bU2% $[#a&
7`cfUZYb]VY
8UibcffiV]W]bU
8clcffiV]W]bU
9d]ffiV]W]bU
=XUffiV]W]bU
=ZcgZUa]XU
=f]bchYWUbc
ClU`]d`Uh]bU

6U]lc
%$!'$

)!:`icfcifUW]`
6cfhYnca]VY
7Yhil]aUVY
7]hUfUV]bU0% $[#a&
8cWYhUlY`
8clcffiV]W]bU`]dcggcaU`
9hcdcg]XY
;YbW]hUV]bU
=lUVYd]`cbU
AYhchfYlUhc
A]hca]W]bU
A]hclUbhfcbU
DUW`]hUlY`
DUb]hiaiaUVY
DYaYhfYlYXY
HYag]fc`]aig
HcdchYWUbc
HfUghiniaUVY

CLASSIFICAO

E COMBINAO DAS DROGAS


QUANTO EMETOGENICIDADE
5gaYX]WUYgih]`]nUXUgbchfUhUaYbhcXcW|bWYf
ZcfaUaia[fidc\YhYfc[bYcWcadchYbW]U`jUf]UXc
XY]bXin]fbzigYUgYja]hcg"BYggY[fidcXYZzfaUWcg
YbWcbhfUa!gYcgU[YbhYgei]a]chYfzd]Wcg giVgh|bW]Ug
\cfacbU]g Ubh]WcfdcgacbcW`cbU]gX]fYW]cbUXcgUdfchYbUg
XYgidYfZW]YXUgW`i`UgcidfchYbUggc`jY]g dYeiYbUg
ac`Wi`Ug]b]V]XcfUgXYh]fcg]bUei]bUgYYcihfcg"
C[fUiXYYaYhc[Yb]W]XUXYXcgU[YbhYgXUXcXY
UWcfXcWcaU]bW]XbW]UXYbzigYUgYja]hcgUggcW]UXU
{giUih]`]nU~cHUV"+Y,Fc]`UYhU`" &$%$"
EiUbXc \z WcaV]bU~c XY Xfc[Ug  c [fUi XY
YaYhc[Yb]W]XUXYXUXcdY`UWcaV]bU~cXcU[YbhY
WcaaU]cf[fUiUWfYgW]XcXc[fUiXYYaYhc[Yb]W]XUXY
XcgXYaU]gU[YbhYgFc]`UYhU`" &$%$"

5[YbhY

5`hU
2-$

<YlUaYh]`aY`Ua]bU
@caigh]bU
DfcWUfVUn]bU

AcXYfUXU
'$!-$

7]W`cZcgZUa]XU
=aUh]b]VY
HYacnc`ca]XU
J]bcfY`V]bU

6U]lU
%$!'$

7UdYW]hUV]bU
9hcdcg]XY
9jYf`]aig
:`iXUfUV]bU
@UdUh]b]VY
@YbU`]Xca]XU
Gib]h]b]VY
HU`]Xca]XU
HY[UZififUW]`

Ab]aU
0%$

*!H]c[iUb]bU
7`cfUaViW]`
9f`ch]b]VY
;YZh]b]VY
<]Xfcl]ifY]U
AY`ZU`Ubc
AYhchfYlUhc
GcfUZYb]VY

(3)

S u p l e m e n t o

PROFILAXIA

DE NUSEAS E VMITOS PSQUIMIOTERAPIA


5dfc`Ul]UaYX]WUaYbhcgUXYbzigYUgYja]hcg
dg!ei]a]chYfUd]U XYjY gYf ZY]hU XY UWcfXc Wca c
dchYbW]U` YaYhc[b]Wc XUg Xfc[Ug ci WcaV]bUYg
ih]`]nUXUgHUV"-Y%$"vgiUaY`\cfZcfaUXYWcbhfc`Y 
^zeiYiaUjYn]b]W]UXUgYhcfbUXYX]ZW]`aUbY^c Wca
WcbgYeibW]Ug dchYbW]U`aYbhY [fUjYg Xc dcbhc XY
j]ghUW`b]WcYdg]Wc`[]Wc"
GY[ibXc gYi bX]WY hYfUdih]Wc  cg U[YbhYg
Ubh]Yah]WcgdcXYagYfW`Ugg]WUXcgYa.%U[YbhYg
XY U`hc bX]WY. UbhU[cb]ghUg )!<H'  Wcfh]Wc]XYg
XYlUaYhUgcbUYUbhU[cb]ghUB?%UdfYd]hUbhY/&
U[YbhYgXYVU]lcbX]WY.aYhcW`cdfUa]XU Vih]fcZYbcbUg 
ZYbch]Un]bUgYWUbUV]bc]XYg/Y'U[YbhYgUX^ijUbhYg.
VYbncX]UnYdb]Wcg `cfUnYdUa  U`dfUnc`Ua Y
Ubh]\]ghUab]WcgX]ZYb]XfUa]bU?f]gYhU`" &$$*"
DUfU YgeiYaUg XY ei]a]chYfUd]U XY U`hU
YaYhc[Yb]W]XUXY UdfYjYb~cU[iXUYhUfX]UXYjYWcbhYf
UWcaV]bU~cXYWcfh]Wc]XY[YfU`aYbhYXYlUaYhUgcbU 
UggcW]UXUUUbhU[cb]ghU)!<H'YUdfYd]hUbhYbcX]UXU
ei]a]chYfUd]U gY[i]XcXYXYlUaYhUgcbUdcfaU]ghfg
X]UgYUdfYd]hUbhYdcfaU]gXc]gX]UgFc]`UYhU`" &$%$"
IaUU`hYfbUh]jUYag]hiUYgYaeiYcUdfYd]hUbhYb~c
X]gdcbjY` Uih]`]nU~cXYUbhU[cb]ghU)!<H'UggcW]UXcU
XYlUaYhUgcbUdcfj]U]bhfUjYbcgUbcX]UXUei]a]chYfUd]U 
gY[i]XcXYghUWcaV]bU~cdcfaU]ghfgX]Ug dcfj]UcfU`"
EiUbXccUbh]Yah]Wcih]`]nUXcUdU`cbcgYhfcbU YghY
XYjYgYfih]`]nUXcgcaYbhYbcX]UXUei]a]chYfUd]UXYj]Xc
UgiU`cb[UaY]U!j]XUGU]hcYhU`" &$$-"
DUfU YgeiYaUg XY acXYfUXU YaYhc[Yb]W]XUXY  U
ih]`]nU~cXYhfgU[YbhYgWcacUW]aUdcXYagYfZY]hU
YadUW]YbhYgfYWYVYbXcUWcaV]bU~cXclcffiV]W]bUY
W]W`cZcgZUa]XU"BcgXYaU]g fYWcaYbXU!gYUWcaV]bU~c
XY UbhU[cb]ghU )!<H' Wca XYlUaYhUgcbU bc X]U XU
ei]a]chYfUd]U gY[i]XcXYXYlUaYhUgcbUdcfXc]gUhfg
X]Ug ciXcU[cb]ghU)!<H'Fc]`UYhU`" &$%$"
DUfUYgeiYaUgXYVU]lUYaYhc[Yb]W]XUXY UdYbUgU
ih]`]nU~cfch]bY]fUXYXYlUaYhUgcbUfYWcaYbXUXU/
cihfUgaYX]WUYgdcXYagYfUX]W]cbUXUgYaW]W`cg
giVgYeiYbhYgWUgccdUW]YbhYUdfYgYbhYbzigYUgY#ci
ja]hcg"DUfUYgeiYaUgXYab]aUYaYhc[Yb]W]XUXY
b~c\zfYWcaYbXU~cdUfUUih]`]nU~cXYUbh]Yah]Wc
Fc]`UYhU`" &$%$"

HUVY`U-"9geiYaUgXYUbh]Yah]WcgfYWcaYbXUXcgYabzigYUgYja]hcgdg!ei]a]chYfUd]UXYUWcfXcWca
cdchYbW]U`YaYhc[b]Wcg?f]gYhU`"&$$*/Fc]`UYhU`" &$%$"
9aYhc[Yb]W]XUXY

9geiYaUUbh]Yah]Wc

8]U

5`hU

5bhU[cb]ghU)!<H'
8YlUaYhUgcbU

%
%U(
%U'

5dfYd]hUbhY

&!7`cfcXYcl]UXYbcg]bU
6YjUW]niaUVY
6`Yca]W]bU
6iggi`ZUbc
:`iXUfUV]bU
J]aV`Ugh]bU
J]bWf]gh]bU
J]bcfY`V]bU

Ab]ac
0%$

2 011;

;fUiXY
YaYhc[Yb]W]XUXY

($!%&$a[

(!&$a[

EFEITOS

B r a s i l e i r a

HUVY`U ," DchYbW]U` YaYhc[b]Wc Xcg U[YbhYg


Ubh]bYcd`zg]Wcgih]`]nUXcgdcfj]UcfU`"

=bhfUjYbcgU

DU`cbcgYhfcb

Re v i s t a

)'((

AcXYfUXU

5bhU[cb]ghU)!<H'
8YlUaYhUgcbU
5dfYd]hUbhY

%
%U'
%U'

6U]lU

8YlUaYhUgcbU

5bhU[cb]ghU)!<H'

Ab]aU

G]bhcazh]Wcg

7cbg]XYfUfUih]`]nU~cXYdU`cbcgYhfcbU"Ca]h]fX]Ug&Y'gYZcfih]`]nUfUdfYd]hUbhY"BUWcaV]bU~c
XclcffiV]W]bUYW]W`cZcgZUa]XU"5`hYfbUh]jUUXYlUaYhUgcbU"
2

Re v i s t a

B r a s i l e i r a

d e

C u i d a d o s

Pa l i a t i v o s

2 011;

(3)

S u p l e m e n t o

(-

)'((

:fej\ejf9iXj`c\`if[\E}lj\Xj\Md`kfj

:fej\ejf9iXj`c\`if[\E}lj\Xj\Md`kfj

SUPLEMENTO2
9aYhc[Yb]W]XUXY

AYX]WUaYbhc

8cgYUbhYgXU
ei]a]chYfUd]U

5`hU

CbXUbgYhfcbU

JC.&(a[
=J.,a[

;fUb]gYhfcbU

JC.&a[
=J.%a[

DU`cbcgYhfcbU

=J.$ &)a[

8YlUaYhUgcbU

JC.%&a[
=J.%&U&$a[

,a[X]Ug&U(

5dfYd]hUbhY

JC.%&)a[

,$a[X]Ug&Y'

CbXUbgYhfcbU

JC.%*a[
=J.,a[

;fUb]gYhfcbU

JC.&a[
=J.%a[

DU`cbcgYhfcbU

IJ.$ &)a[

8YlUaYhUgcbU

JC.%&a[
=J.,U%$a[

,a[X]Ug&U(

5dfYd]hUbhY

JC%&)a[

,$a[X]Ug&Y'

AcXYfUXU

NUSEA

E VMITOS NA OBSTRUO
INTESTINAL
CVghfi~c]bhYgh]bU`dcXYhYfX]jYfgUgWUigUgWcac
aYW|b]WUgciaYhUV`]WUg YgYfWcad`YhUcidUfW]U`
giVcW`ig~c]bhYgh]bU`"9adUW]YbhYgWcacVghfi~c
aYW|b]WU YgdYW]U`aYbhYbUgXcYbUgb~caU`][bUg U
UVcfXU[YaXYYgWc`\UW]ff[]WU YUaY`\cfZcfaUXY
Wcbhfc`YXYbzigYUgYja]hcgdY`UdUggU[YaXYWUhYhYf
bUgc[zghf]WcUhcWcbhfc`YXceiUXfccVghfih]jc"
DUW]YbhYg eiY UdfYgYbhUa giVcW`ig~c aYW|b]WU
fYgi`hUbhYXYWUfW]bcaUhcgYdYf]hcbYU` ZfYeiYbhYaYbhYb~c
g~cWUbX]XUhcg{W]fif[]U eiYfdY`U[fUbXYUXYfbW]UYbhfYUg
U`Ug]bhYgh]bU]gUVXcaYWcb[Y`UXc caYbhU`WU_Y eiYfdY`U
ai`h]d`]W]XUXYXYdcbhcgXYcVghfi~c cidY`UgWcbX]Yg
W`b]WUdfYWzf]Ug"DUfUYggYgdUW]YbhYg fYWcaYbXU!gYcigc
XYW`]ghYf[`]WYf]bUXcdUfUZUW]`]hUfUY`]a]bU~cXYZYnYg
YbXifYW]XUgbUUadc`UfYhU`"@UlUbhYgg~cWcbhfU]bX]WUXcg
bYggYgWUgcg YgdYW]U`aYbhYcgYgh]ai`UbhYg df]bW]dU`aYbhY
gYcdUW]YbhYgYYbWcbhfUfYacVghfi~cWcad`YhU"5ih]`]nU~c
XYXYlUaYhUgcbUdcfj]UdUfYbhYfU`dcXYWcbhf]Vi]fdUfUU
fYjYfg~cXUcVghfi~c]bWcad`YhU"DUW]YbhYgWcaW`]WUg
dcXYafYWYVYf\]cgW]bU6cmX &$$,"
5ZU`bW]UXUdYf]ghU`gY`YcdUfU`h]WcdcXYgYfWUigUXU
dcfbYifcdUh]UUihcba]WU WUfW]bcaUhcgYdYf]hcbYU` 
X]ghfV]cgaYhUV`]WcgciYghUffY`UW]cbUXUUaYX]WUYg 
hU]gWcaccd]zWYcgYU`WU`]XYgXUj]bWU"9ghYgdUW]YbhYg
XYjYf]bhYffcadYfUih]`]nU~cXYaYX]WUYgWcbgh]dUbhYg
\]cgW]bU UbhU[cb]ghUg)!<H' Ua]hf]dh]`]bU XYjYafYWYVYf
aYX]WUYgdf!W]bh]WUgaYhcW`cdfUa]XUY`UlUh]jcg"
DUW]YbhYgYaigcXYcd]zWYcgXYjYagYfUjU`]UXcgeiUbhc
UcigcXYZYbhUb]`hfUbgXfa]Wc"DUfUdUW]YbhYgWca[fUbXY
X]ghYbg~cUVXca]bU`XYj]Xc{gYWfY~c]bhYgh]bU` Yghz
fYWcaYbXUXccigcXYcWhfYchXYc6cmX &$$,"

BcgX]UggY[i]bhYg

9adUW]YbhYgih]`]nUbXcUdfYd]hUbhYUXcgYXYXYlUaYhUgcbUXY%&a[ dUfUcgXYaU]g &$a["


=J.]bhfUjYbcgc/JC.j]UcfU`"
DUW]YbhYg Ya ei]a]chYfUd]U XY a`h]d`cg X]Ug
Wca W]gd`Uh]bU XYjYa fYWYVYf ia UbhU[cb]ghU )!
<H'aU]gXYlUaYhUgcbUdUfUdfYjYb~cXYbzigYUg
Yja]hcgU[iXcgYXYlUaYhUgcbUdUfUdfYjYb~cXcg
g]bhcaUghUfX]cg9]b\cfbYhU`" &$%%"

TRATAMENTO

DE NUSEAS E VMITOS
REFRATRIOS
5`[ibg dUW]YbhYg  UdYgUf XU hYfUd]U dfcZ]`zh]WU
]bgh]hiXU Yjc`iYaWcaja]hcgdg!ei]a]chYfUd]U"
BYghYg XYjYa gYf fYUjU`]UXcg U YaYhc[Yb]W]XUXY Xc
hfUhUaYbhc cgZUhcfYgXYf]gWcXcdUW]YbhY Ug]hiU~c
UhiU`XUXcYbU WcacfV]XUXYgYaYX]WUYgYaigc"
7cbg]XYfUfUUX]~cXY`cfUnYdUaciU`dfUnc`Ua ciU
giVgh]hi]~cXcUbhU[cb]ghU)!<H'dcfaYhcW`cdfUa]XU
YaU`hUgXcgYg?f]gYhU`" &$$*"

NUSEAS

BzigYUgYja]hcgdg!fUX]chYfUd]UhafY`U~c
WcaUhWb]WUXUfUX]chYfUd]Ujc`iaYY`cWU`]nU~c
XU zfYU ]ffUX]UXU  XcgY Y c ZfUW]cbUaYbhc XU
]ffUX]U~c  Wca ZUhcfYg fY`UW]cbUXcg Uc dUW]YbhY
[bYfc YghUXc[YfU` ]XUXY ei]a]chYfUd]UfYWYbhY
ci WcbWcffYbhY  YlhYbg~c XU XcYbU bYcd`zg]WU Y
WcagYigUgdYWhcgdg]Wc`[]Wcg"
8Y UWcfXc Wca U zfYU ]ffUX]UXU  dcXY!gY
W`Ugg]Z]WUfcdchYbW]U`YaYhc[b]WcXUfUX]chYfUd]U
YaU`hc2-$ acXYfUXc*$U-$ VU]lc'$
U*$ciab]ac0'$?f]gYhU`" &$$*/Fc]`U
YhU`" &$%$"
8YggUW`Ugg]Z]WU~cXYWcffYgiUdfcZ]`Ul]UHUV"
%%Fc]`UYhU`" &$%$"

9aYhc[Yb]W]XUXY

fYU]ffUX]UXU

5bh]Yah]WcgfYWcaYbXUXcg

5`hU

7cfdchchU`H6=
=ffUX]U~cbcXU`hchU`HB=

DfcZ]`Ul]U Wca UbhU[cb]ghU )!<H' 


XYlUaYhUgcbUUWUXUZfU~c

AcXYfUXU

5VXcaYgidYf]cf
=ffUX]U~cXY\Ya]WcfdcgidYf]cf
=ffUX]U~cXY\Ya]Wcfdc]bZYf]cf

Dfc`Ul]U Wca UbhU[cb]ghU )!<H' #!


XYlUaYhUgcbUUWUXUZfU~c

6U]lU

7f|b]c
7f|b]c!Ygd]b\U`
7UVYUYdYgWcc
HfUl
DY`jY

Dfc`Ul]UcifYg[UhYWcaUbhU[cb]ghU
)!<H'

Ab]aU

AUaU
9lhfYa]XUXYg

FYg[UhY Wca aYhcW`cdfUa]XU ci


UbhU[cb]ghU)!<H'

d e

C u i d a d o s

Pa l i a t i v o s

2 011;

(3)

S u p l e m e n t o

NUSEAS

E VMITOS NO PACIENTE FORA DE


POSSIBILIDADE DE CURA
BYggYgdUW]YbhYgXYjYgYf]XYbh]WUXccaYWUb]gac
WUigUXcf U Z]a XY Ud`]WUf U hYfUd]U Ubh]Yah]WU
aU]g UXYeiUXU" DUfU dUW]YbhYg Wca bzigYUg
Wfb]WUg  ZfYeiYbhYaYbhY UggcW]UXUg U YgjUn]UaYbhc
[zghf]Wc `Ybhc  cg Ubh]Yah]Wcg XYjYa gYf ih]`]nUXcg
dfYZYfYbW]U`aYbhY dcf j]U fYhU`" AYhcW`cdfUa]XU
dfcacjY c YgjUn]UaYbhc [zghf]Wc dY`U ]b]V]~c Xcg
fYWYdhcfYgXcdUa]bf[]WcgbcYghaU[c Ygh]ai`Ucg
fYWYdhcfYg)!<H(dYf]Zf]WcgeiYUiaYbhUaUgYWfY~c
XY UWYh]`Wc`]bU bc d`Ylc a]cYbhf]Wc  Y dfcacjY U
dYf]ghU`gY;i]XY`]bYB7;!*$*+ &$$*"
5YgWc`\UXcUbh]Yah]WcXYdYbXYXcaYWUb]gac
eiY`YjUUbzigYUgYja]hcg YcgfYWYdhcfYgYbjc`j]Xcg.
Xfc[Ugdfc!W]bh]WUgaYhcW`cdfUa]XUYXcadYf]XcbU
dUfU [Ughf]hY ci YghUgY [zghf]WU/ aYhcW`cdfUa]XU ci
\U`cdYf]Xc` dUfU bzigYUg Y ja]hcg WUigUXcg dcf
Ygh]ai`U~cZUfaUWc`[]WUbUncbUXc[Uh]`\ccd]zWYcg 
\]dYfWU`WYa]Uci]bgiW]bW]UfYbU`/UbhU[cb]ghUg)<H!
'YaWcaV]bU~cWcaXYlUaYhUgcbUdUfUbzigYUg
Y ja]hcg dg!cdYfUhf]cg/ Wcfh]Wc]XYg dUfU eiUXfcg
fY`UW]cbUXcg{\]dYfhYbg~c]bhfUWfUb]UbUcifYg]ghYbhY
UcihfcgUbh]Yah]Wcg/W]W`]n]bUYYgWcdc`Ua]bUeiUbXc
UYh]c`c[]UhYacf][YajYgh]Vi`Uf"7YfWUXY'$XcgWUgcg
bYWYgg]hUaXYiaUUVcfXU[YaWcaV]bUXUWcaU[YbhYg
XYW`UggYgX]gh]bhUg"

SUMRIO

DO TRATAMENTO MEDICAMENTOSO
5 HUVY`U %& hfUn giaUf]UaYbhY c hfUhUaYbhc
aYX]WUaYbhcgcdUfUbzigYUgYja]hcgYadUW]YbhYg
cbWc`[]Wcg 6Ybh`Ym  6cmX  &$$%/ @]W\hYf  %--'/
GhYd\Ybgcb8Uj]Yg &$$*"

HUVY`U%&"GbXfcaYgUggcW]UXUgUbzigYUgYja]hcgYadUW]YbhYgWcaW|bWYfYaWi]XUXcgdU`]Uh]jcg"

E VMITOS PS-RADIOTERAPIA

EiUXfcW`b]Wc

7UigUg

9ghUgY[zghf]WU

BzigYUgdfYXca]bUbhYg
D]cfUWcaU`]aYbhU~c
BzigYU aY`\cfU Udg
ja]hc
F<5bcfaU]gci
X]a]biXcg

7|bWYfXYYghaU[c
<YdUhcaY[U`]U ci UgW]hY Wca
WcadfYgg~c[zghf]WU
BYifcdUh]UdUfUbYcd`zg]WU
BYifcdUh]UX]UVh]WU
AYX]WUaYbhcgcd]c]XYg

BzigYUgdfYXca]bUbhYg
DciWU aY`\cfU Udg
ja]hc
5[fUjUXc dY`c W\Y]fc XU
Wca]XU

<]dYfWU`WYa]U
AYhzghUgYg\Ydzh]WUg
IfcdUh]UcVghfih]jU
CVghfi~c]bhYgh]bU`
Cd]c]XYg
Ei]a]chYfUd]U

DfcW`cfdYfUn]bU
<U`cdYf]Xc` 
@YjcaYdfcaUn]bU
5bhU[cb]ghUg)!<H'
5bhU[cb]ghUgB?%
8YlUaYhUgcbU

<]dYfhYbg~c
]bhfUWfUb]UbU

BzigYUgYja]hcg
D]cfdY`UaUb\~
DcXYhYfg]bU]g
bYifc`[]Wcg

HiacfYgWYfYVfU]gdf]azf]cgci
gYWibXzf]cg
5WcaYh]aYbhcaYbb[Yc

7cfh]WcghYfc]XYg

JYgh]Vi`Uf

BzigYUgYja]hcg
5[fUjUXUdY`cacj]aYbhc
XUWUVYU

AYhzghUgYgWYfYVfU]g
IgcXYcd]c]XYg
JYgh]Vi`cdUh]U

CVghfi~c
]bhYgh]bU`#
X]gach]`]XUXY

DUfW]U`.F<5X]a]biXcgYa
WUgcXY`Yc UiaYbhUXcgbU
cVghfi~cdUfW]U`"5`[ia
acj]aYbhc]bhYgh]bU`
7cad`YhU. Xcf Ya W`]WU
WcbghUbhY" 5igbW]U XY
Uhi`bW]Uciacj]aYbhcg
]bhYgh]bU]g

7|bWYf]bhYgh]bU`
7UfW]bcaUhcgYdYf]hcbYU`
5gW]hY
6f]XUg
7cbgh]dU~c

DfcaYhUn]bU
AYW`]n]bU
DfcW`cfdYfUn]bU
8]aYb]Xf]bUhc
DUfW]U`.
AYhcW`cdfUa]XU
7cfh]WcghYfc]XYg
7cad`YhU.
<U`cdYf]Xc`
7cfh]WcghYfc]XYg
5bh]!\]ghUab]Wc
CWfYch]XY
@YjcaYdfcaUn]bU

BzigYUgcija]hcg
]bhYfa]hYbhYg
5bg]YXUXYUggcW]UXU
F<5.fiXcg\]XfcUfYcg"

5bg]YXUXY

HfUhUaYbhc
aYX]WUaYbhcgc
AYhcW`cdfUa]XU
8cadYf]XcbU
6fcacdf]XU

GbXfcaY

Metablicos

HUVY`U%%"5bh]Yah]WcgdUfUdfYjYb~cXYbzigYUgYja]hcgdg!fUX]chYfUd]U"

B r a s i l e i r a

(.

SUPLEMENTO 2

HUVY`U%$"8cgYgYj]UgXYUXa]b]ghfU~cXcgUbh]Yah]WcggY[ibXccdchYbW]U`YaYhc[b]Wcg"

Re v i s t a

)'((

Re v i s t a

B r a s i l e i r a

d e

5bg]YXUXY

C u i d a d o s

Pa l i a t i v o s

6YbncX]UnYdb]Wcg
Hf]WW`]Wcg
DfcW`cfdYfUn]bU

2 011;

(3)

S u p l e m e n t o

(/

)'((

:fej\ejf9iXj`c\`if[\E}lj\Xj\Md`kfj

:fej\ejf9iXj`c\`if[\E}lj\Xj\Md`kfj

SUPLEMENTO2
MEDICAMENTOSO EM PEDIATRIA
BzigYUgYja]hcgg~caUb]ZYghUYgW`b]WUgaU]g
Wcaibg bcg dUW]YbhYg dYX]zhf]Wcg eiY bcg UXi`hcg
@i]g]YhU`" &$$*/Fc]`UYhU`" &$$) YYgh~cWcaiaYbhY
dfYgYbhYgYaWf]UbUggcVWi]XUXcgdU`]Uh]jcg"
5gXfc[UgigUXUgbUdfYjYb~cYhfUhUaYbhcXYbzigYU
Yja]hcg]bW`iYacgUbh]Yah]WcgYcihfcgU[YbhYgeiYg~c
igUXcgdUfUdchYbW]U`]nUfUU~cXcgUbh]Yah]Wcg"
<z dciWcg YghiXcg fUbXca]nUXcg Y Wcbhfc`UXcg
Ya Wf]UbUg dUfU U dfYjYb~c XY bzigYUg Y ja]hcg"
5`[iaUg jYnYg  ]bUdfcdf]UXUaYbhY cg fYgi`hUXcg XY
YghiXcgYaUXi`hcgg~cYlhfUdc`UXcgdUfUUgWf]UbUg 
dcfa gYa `YjUf Ya Wcbg]XYfU~c eiY \z X]ZYfYbUg
bUaYhUVc`]nU~cXUgXfc[UgYbU]bW]XbW]UXYYZY]hcg
UXjYfgcgYbhfYUgX]ZYfYbhYgZU]lUgYhzf]Ug"

ANTAGONISTAS 5-HT3

CgUbhU[cb]ghUgXcgfYWYdhcfYg)!<H'g~cUbh]Yah]Wcg
dchYbhYgWcaiaUUad`UaUf[YahYfUdih]WU"CgYi
XYgYbjc`j]aYbhc bU XWUXU XY %-,$ Y U ih]`]nU~c
[YbYfU`]nUXU bU XWUXU XY %--$ fYjc`iW]cbUfUa U
dfYjYb~c XY bzigYUg Y ja]hcg Ya dUW]YbhYg Wca
W|bWYf" 5bhYg XU X]gdcb]V]`]XUXY XYggYg U[YbhYg  U
YWzW]UXcgUbh]Yah]WcgaU]gUad`UaYbhYih]`]nUXcg 
aYhcW`cdfUa]XUYZYbch]Un]bUg YfUgYjYfUaYbhY`]a]hUXU
XYj]XcUcgYZY]hcgWc`UhYfU]gYlhfUd]fUa]XU]g"
9aVcfU cg YghiXcg dYX]zhf]Wcg fY`UW]cbUXcg
Uc hYaU gY^Ua `]a]hUXcg  [fUbXYg X]ZYfYbUg XU
`]hYfUhifU YbhfY UXi`hcg Y Wf]UbUg UXi`hcg b~c
ZcfUa ]XYbh]WUXcg" CbXUbgYhfcbU Zc] c df]aY]fc
UbhU[cb]ghU Xcg fYWYdhcfYg )!<H' X]gdcbjY`
WcaYfW]U`aYbhYbcg9ghUXcgIb]Xcg"DUfUcWcbhfc`Y
Xcg g]bhcaUg U[iXcg Ya UXi`hcg  cbXUbgYhfcbU 
U`hUaYbhYYZYh]jcYgidYf]cf{aYhcW`cdfUa]XU8Y
Ai`XYf Yh U`"  %--$" GiU YZ]WzW]U  fYZcfUXU dY`U
UX]~c XY XYlUaYhUgcbU 5`jUfYn Yh U`"  %--)" 5
aU]cf]U Xcg YghiXcg ]b]W]U]g Ya UXi`hcg ih]`]nUfUa
ia YgeiYaU XY hfg XcgYg dcf j]U ]bhfUjYbcgU XY
$ %)a[#_[dcfXcgY ci,a[dcfXcgY WcacigYa
aUbihYb~c cfU` giVgYeiYbhY" 9ghiXcg dcghYf]cfYg
Wca UXi`hcg acghfUfUa eiY cg fY[]aYg XY XcgY
b]WU XY %* U '& a[ g~c dY`c aYbcg h~c YZ]WUnYg
eiUbhc U XcgY X]j]X]XU Y \z VYbYZW]cg XU UX]~c
XY XYlUaYhUgcbU" 5 hcl]W]XUXY bU aU]cf]U Xcg
YghiXcghYag]Xcab]aUYWcbg]ghYdf]bW]dU`aYbhY
XY WYZU`Y]U %$ U %)  Y`YjU~c hfUbg]hf]U XUg
hfUbgUa]bUgYg\Ydzh]WUg*U,YWcbgh]dU~c)"
9ghiXcgb~cfUbXca]nUXcgdYX]zhf]WcgXYacbghfUfUa
eiYUcbXUbgYhfcbUYWUnYaWf]UbUgeiYfYWYVYa
iaUjUf]YXUXYXYU[YbhYgei]a]chYfzd]WcgYfUX]U~c
<Ug`Yf Yh U`"  &$$,/ 7cfUdW]c[`i  GUfdYf  &$$)"
9ghiXcg fUbXca]nUXcg Wca cbXUbgYhfcbU bU ZU]lU
Yhzf]UdYX]zhf]WUacghfUagiUaU]cfYWzW]UeiUbXc
WcadUfUXU{aYhcW`cdfUa]XU"8cgYggidYf]cfYgU)
a[#ab~cUiaYbhUaUYWzW]U aUgg]aUX]~cXY
XYlUaYhUgcbU" Cg YghiXcg gcVfY cbXUbgYhfcbU Ya
Wf]UbUg YagiUaU]cf]U ih]`]nUfUaYgeiYaUgXYhfg
XcgYgX]zf]UgXY$ %)a[#_[dcfXcgY ci)a[#a&dcf
XcgY6fcW_YhU`" %--*/>f[YbgAWEiUXY %--&"
;fUb]gYhfcbU[YfU`aYbhYUXa]b]ghfUXUYaXcgY
b]WUdcfj]U]bhfUjYbcgUcicfU`UbhYgXUUXa]b]ghfU~c
XYei]a]chYfUd]U"DUfUcWcbhfc`YXcgg]bhcaUgU[iXcg 
U WcaV]bU~c XY XYlUaYhUgcbU Y [fUb]gYhfcbU 
aU]gYWUnXceiYgcaYbhY[fUb]gYhfcbU"9aYghiXc
fUbXca]nUXc Y Xid`c WY[c  b~c \cijY X]ZYfYbU
YbhfY Ug XcgYg XY %$ Y ($ [#_[ dUfU c Wcbhfc`Y XY
bzigYUgYja]hcgYa%,Wf]UbUgfYWYVYbXcYgeiYaU
ei]a]chYfzd]Wc VUgYUXc Ya WUfVcd`Uh]bU 6YffU_ Yh
U`"  &$$+" DcfhUbhc  U XcgU[Ya dYX]zhf]WU UXYeiUXU
XY[fUb]gYhfcbUU]bXUb~cYghzW`UfU"5fYWcaYbXU~c
XcZUVf]WUbhYXY%$[#_["CgXUXcggcVfYUYWzW]U
fY`Uh]jU XY &$ Y ($ [#_[ g~c WcbZ`]hUbhYg" 9ghiXcg
gcVfYcigccfU`XY[fUb]gYhfcbUYaWf]UbUgb~cZcfUa
YbWcbhfUXUgbU`]hYfUhifUaX]WU"
B r a s i l e i r a

(0

SUPLEMENTO 2

TRATAMENTO

Re v i s t a

)'((

d e

C u i d a d o s

CORTICOSTEROIDES

HUVY`U%'"5bh]Yah]WcgYaWf]UbUgdUfUja]hcgYbzigYUg]bXin]Xcgdcfei]a]chYfUd]U"

9aVcfUgYiaYWUb]gacXYU~cb~cgY^UhchU`aYbhY
WcadfYYbX]Xc  cg YghYfc]XYg ha g]Xc igUXcg Wcac
U[YbhYg Ubh]Yah]Wcg" 5 XYlUaYhUgcbU  c aU]g
YghiXUXc WcaXcgYgjUf]UbXcXY)U(,a[YaXcgY
b]WUYa`h]d`U"9ghiXcgfYWYbhYgacghfUaXcgYgXY%$
U&$a[UcX]U UhW]bWcXcgYgX]zf]UghchU`]nUbXc%&$
a["BUdfzh]WUW`b]WUgiUXcgYjUf]UXY%$U%(a[#a&
5bhcbUfU_]gYhU`" &$$( <c`Xgkcfh\YhU`" &$$*"
7cfh]Wc]XYgacghfUfUagYfaU]gYZYh]jcgUbh]Yah]Wcg
eiY W`cfdfcaUn]bU Y aYhcW`cdfUa]XU 6UgUXY Yh U" 
&$$*/AY\hUYhU`" %-,*"
8YlUaYhUgcbU igUXU ]gc`UXUaYbhY hYa YZ]WzW]U
Ubh]Yah]WUacXYfUXU aUgdcXYdchYbW]U`]nUfUU~c
XYcihfcgUbh]Yah]WcgAUfg\U``YhU" %-,-"5UX]~cXY
XYlUaYhUgcbUaY`\cfUg][b]Z]WUh]jUaYbhYcWcbhfc`YXY
ja]hcgYadUW]YbhYgeiYfYWYVYfUaaYhcW`cdfUa]XUYhcXcg
cgUbhU[cb]ghUgXcgfYWYdhcfYg)!<H'5`jUfYnYhU`" %--)"

FENOTIAZINAS

BUgXcgYghYfUdih]WUgigiU]g ZYbch]Un]bUgXYdf]aYa
U Uh]j]XUXY XU ncbU XY [Uh]`\c Xc ja]hc Y hUaVa
dcXYaXYdf]a]fX]fYhUaYbhYcWYbhfcXcja]hc"
5 W`UggY XY \]XfcWUfVcbYhcg U`]Zzh]Wcg  XUg eiU]g
U W`cfdfcaUn]bU  c dfchh]dc  hYa `]a]hUXc YZY]hc
Ubh]Yah]WcYYghzUggcW]UXU{]bW]XbW]UfY`Uh]jUaYbhYU`hU
XY\]dchYbg~ccfhcghzh]WU gYXU~cYX]gWfUg]UggUb[ibYUg"
FYUYgYlhfUd]fUa]XU]gciU[]hU~cg~ccgdf]bW]dU]g
YZY]hcgUXjYfgcgXYggYgaYX]WUaYbhcg Wi^U]bW]XbW]U
dcXYgYfX]a]biXUUcgYZUnYfUUXa]b]ghfU~c]bhfUjYbcgU
`YbhU()U*$a]bihcgYUggcW]z!`cgUiaUbh]!\]ghUab]Wc
WcacUX]ZYb]XfUa]bU"9aVcfU[YfU`aYbhY]aYX]Uhcg cg
YZY]hcgWc`UhYfU]gYlhfUd]fUa]XU]gdcXYaUdUfYWYfUh(,
\cfUgUdgUUXa]b]ghfU~cXUXfc[U"5gg]a fYWcaYbXUa!
gYXcgYgfYdYh]XUgXYX]ZYb]XfUa]bUdUfU&(\cfUgdUfU
dUW]YbhYgeiYfYWYVYaWifgcgdfc`cb[UXcgXYZYbch]Un]bUg"
:Ybch]Un]bUg g~c UXa]b]ghfUXUg dcf j]U ]bhfUjYbcgU 
]bhfUaigWi`Uf cfU`YfYhU`"5gXcgYgg~cXY%$a[UWUXU
*U,\cfUgdUfUWf]UbUgXY%&UbcgciaU]g Y)a[dUfU
Wf]UbUgaYbcfYg"

DE RECEPTORES DE NK1
;cfYYhU`"&$$-UjU`]UfUacigcXYUdfYd]hUbhYYa
&,UXc`YgWYbhYgYbhfY%%Y%-UbcgXY]XUXYYaYghiXc
fUbXca]nUXc"5XcgYXY%&)a[bcdf]aY]fcX]UY,$
a[bcgX]Ug&Y'g~c][iU]g{gigUXUgbcUXi`hc"<cijY
fYgdcghUWcad`YhUXY') +bc[fidcUdfYd]hUbhYWcbhfU
) *bc[fidcWcbhfc`YB1%, dcfaYggUX]ZYfYbU
b~cZc]YghUh]gh]WUaYbhYg][b]WUbhY"5hiU`aYbhYb~c\z
fYWcaYbXU~cdUfUcigcXYUbhU[cb]ghUgXYfYWYdhcfYg
XYB?%dUfUWf]UbUgYUXc`YgWYbhYg"
5HUVY`U%'UdfYgYbhUUgfYWcaYbXUYgVUgYUXUgbc[i]U
XUiaAi`h]bUh]cbU`5ggcW]Uh]cbcZGiddcfh]jY7UfY]b7UbWYf
A5G77Y9ifcdYUbGcW]YhmcZAYX]WU`CbWc`c[m9GACdUfU
Wcbhfc`YXYbzigYUgYja]hcgYaWf]UbUgYUXc`YgWYbhYg
UVU]lcXY%,UbcgXY]XUXY>cfXUbYhUh" &$%%"

(3)

S u p l e m e n t o

;fUiXYfYWcaYbXU~c

5`hc

8]U%XYhfUhUaYbhc)<H'
XYlUaYhUgcbU

AcXYfUXc#U`hc

8]U&!'XYhfUhUaYbhcgYa
fYWcaYbXU~cdcggjY`

B~cUd`]WzjY`

B~cUd`]WzjY`

AcXYfUXc

8]U%)<H'UbhU[cb]ghU
XYlUaYhUgcbU

AcXYUfXc#U`hc

6U]lc

BYb\iaUfYWcaYbXU~c
dcggjY`

B~cUd`]WzjY`

B~cUd`]WzjY`

PRTICAS

5dfcl]aUXUaYbhY,)XcgdUW]YbhYgcbWc`[]Wcg
ih]`]nUahYfUd]UgWcad`YaYbhUfYgbcXYWcffYfXYgYi
hfUhUaYbhc8cUb %--,/F]W\UfXgcbYhU`" &$$$ XYbhfY
UgeiU]g UhcaYX]W]bU"
9ghiXcgacghfUaeiYc[Yb[]VfYN]b[]VYfcZW]bU`Y
iaUbh]Yah]WcbUhifU` WcaV]bUXcUdfYdUfUYgb~c
zW]XUgYUggcW]UXcU]b[fYX]YbhYgbYihfcgYfYZfYgWUbhYg 
UdfYgYbhUbXc YZY]hc X]fYhc bc hfUhc [Ughfc]bhYgh]bU`
UhfUjgXYgiUgdfcdf]YXUXYgUfcazh]WUg WUfa]bUh]jUgY
UVgcfjYbhYg UiaYbhUbXcUUXgcf~cXYhcl]bUgYzW]Xcg 
chbigYUach]`]XUXY]bhYgh]bU`5fUi^cYhU`" &$$-"
GiU ih]`]nU~c acghfci!gY dcg]h]jU Ya fYXin]f cg
g]bhcaUgXYbzigYUYja]hcbcdg!cdYfUhf]cD]``U]Yh
U`" &$%%/AUlYhU`" &$$-"D]``U]YhU`"&$%% YaYghiXc
dfcgdYWh]jc Xid`cWY[cYfUbXca]nUXceiYUggcW]cic
[Yb[]VfYYaWzdgi`UgUchfUhUaYbhcaYX]WUaYbhcgcg
dUXf~ccbXUgYhfcbUYXYlUaYhUgcbUYaWf]UbUgY
UXi`hcg ^cjYbg  acghfUfUa aY`\cfU bcg eiUXfcg XY
bzigYUgYja]hcgYaWcadUfU~cUc[fidcd`UWYVc"5g
XcgYgjUf]UjUaXY%*+a[dUW]YbhYgYbhfY&$Y($_[Y
($$a[YbhfY($Y*$_[XiUgjYnYgUcX]U"
9ghiXc ai`h]!ZUgY ==#=== fUbXca]nUXc  Wcbhfc`UXc
Wca d`UWYVc  Xid`c!WY[c  Wca *(( dUW]YbhYg Wca
bzigYUg XYWcffYbhY XY ei]a]chYfUd]U UjU`]ci U
YWzW]UXc[Yb[]VfYj]UcfU`"5gXcgYgXY$ )[U% )
[ XY [Yb[]VfY X]Uf]UaYbhY XifUbhY cg hfg W]W`cg
XY ei]a]chYfUd]U fYXin]fUa g][b]Z]WUh]jUaYbhY Ug
bzigYUg WcaaU]cfYZY]hcbUgeiUbh]XUXYgXY$ )[U
%[FmUbYhU`" &$$-"5gXcgYgUXa]b]ghfUXUgdcXYa
W\Y[UfU&[ jUf]UbXcXYiaUUXiUghcaUXUgUcX]U
F\cXYgAW8Ub]Y` &$$%/DUbYhU`" &$$$/D]``U]YhU`" 
&$%$/N]W_YhU`" &$$,/@Yj]bYYhU`" &$$+"
9a aYhUbz`]gY XU VUgY XY XUXcg 7cW\fUbY
7\U]mU_ibUdfi_YhU`" &$$* ZcfUaYbWcbhfUXcgW]bWc
YghiXcgfUbXca]nUXcg Xid`cWY[cgYWcbhfc`UXcgdcf
d`UWYVc eiY UjU`]UjUa U YZ]WzW]U Xc [Yb[]VfY dUfU U
dfYjYb~cXYbzigYUgYja]hcgbcdg!cdYfUhf]c"Cg
UihcfYgWcbW`ifUaeiYUXcgYXYdY`caYbcg%[dcXY
fYXin]f g][b]Z]WUh]jUaYbhY U ]bW]XbW]U XY bzigYUg Y
ja]hcgdg!cdYfUhf]cgeiUbXcWcadUfUXcUcd`UWYVc 
YaW]fif[]Ug[]bYWc`[]WUgYXUYlhfYa]XUXY]bZYf]cf"
MUaUXUYhU`"&$$'diV`]WUfUagiUgcVgYfjUYg
dfY`]a]bUfYg gcVfY c igc XU WcaV]bU~c XY W]bWc
Z]hcaYX]WUaYbhcg 5`]gaUh]g f\]ncaU  5hfUWhm`cX]g
`UbWYUY f\]ncaU  Dc`mdcfig  <cY`Yb Y 7]bbUaca]
WcfhYl dUfU hfUhUf bzigYUg Y X]gdYdg]U dfcjcWUXU

ANTAGONISTA

A5G77 bjY` XY WcbZ]!


XbW]U W]Ybh]Z]WU# bjY`
XYWcbgYbgc

FITOMEDICAMENTOS

AYhcW`cdfUa]XU iaXYf]jUXcdfcWU]bUa]XU hYaU~c


WYbhfU`YdYf]Zf]WUWcacUbh]Yah]Wc.]b]VYU]bXi~cXY
ja]hcYUWY`YfUcYgjUn]UaYbhc[zghf]Wc"8Yj]Xc{giU
aY]U!j]XUWifhU Y`UXYjYgYfUXa]b]ghfUXUWcaZfYeibW]U"
CfY[]aYdUXf~cYaUXi`hcgZc]XY&a[#_[UWUXU'$
a]bihcgUbhYgXUei]a]chYfUd]UYbcjUaYbhY%\'$ '\'$ 
)\'$ Y,\'$UdgUei]a]chYfUd]U"8UXcgYadf]Wcg
]bX]WUaeiYiaUXcgYXY%a[#_[dcfj]U]bhfUjYbcgU
XifUbhY*$a]bihcg fYdYh]XUUWUXU&!(\cfUgdUfUia
hchU`XYW]bWcXcgYgYWUn"5gWf]UbUgYgh~cgcVaU]cf
f]gWcXYg]bhcaUgYlhfUd]fUa]XU]gXceiYcgUXi`hcgY
Ugg]aUdfc`Ul]UWcaX]ZYb]XfUa]bUfYWcaYbXUXU
;fU\Ua!Dc`Y YhU`"  %-,*" BchY!gY eiY XcgYg ai]hc
aYbcfYgXYaYhcW`cdfUa]XUdcfYlYad`c $ &a[#_[U
WUXU*\cfUgg~cYWUnYgdUfUUbzigYUdg!cdYfUhf]Uci
dUfUUUWY`YfU~cXcYgjUn]UaYbhc[zghf]Wc"

2 011;

;i]XY`]bYg YaWf]UbUg

MEDICINAS COMPLEMENTARES
INTEGRATIVAS

METOCLOPRAMIDA

Pa l i a t i v o s

F]gWcXYja]hc

Re v i s t a

B r a s i l e i r a

d e

C u i d a d o s

dcf]b]V]XcfYgXUfYWYdhU~cXUgYfchcb]bU Yaj]bhY
dUW]YbhYg"<cijYfYgdcghUZUjcfzjY`Ya%'dUW]YbhYg"

HOMEOPATIA

ChfUhUaYbhc\caYcdzh]WcdUfUfYUYgUXjYfgUg
UchfUhUaYbhccbWc`[]WcZc]fYj]ghcdcf?UggUVYhU`"
&$$- UhfUjgXUgVUgYgXYXUXcg7cW\fUbYDUDUGHf]U`g
FY[]ghYf 7cW\fUbY7YbhfU`FY[]ghYfcZ7cbhfc``YXHf]U`g
79BHF5@ A98@=B9 9aVUgY 7=B5<@ 6B= 7UbWYf@=H 
5A98 7=G7CA <ca!=bZcfa G=;@9 BUh]cbU`FYgYUfW\
FY[]ghYf  NYhcW  kkk"Wcbhfc``YX!hf]U`g"Wca/ \hhd.##
W`]b]WU`hf]U`g"[cj Y @][U AYX]Wcfia <caYcdUh\]WU
=bhYfbUh]cbU`]g":c]gY`YW]cbUXciaYghiXcWcbhfc`UXcY
fUbXca]nUXc eiYb~cacghfciVYbYZW]cXUaYX]WU~c
\caYcdzh]WU Ya fY`U~c Uc d`UWYVc dUfU bzigYUg Y
ja]hcgYa*)dUW]YbhYgfYWYVYbXcei]a]chYfUd]UdUfU
W|bWYfXYaUaU8UiV &$$)"
CgaYX]WUaYbhcg\caYcdzh]WcgigUXcgYahcXcg
cgc]hcYghiXcg]XYbh]WUXcgdY`UfYj]g~cb~cWUigUfUa
YjYbhcUXjYfgc]adcfhUbhY hUadciWc]bhYfU~cWcac
hfUhUaYbhcWcbjYbW]cbU`"
5dYgei]gUbc<caYc]bXYl6]V`]c[fUU6fUg]`Y]fU
XY<caYcdUh]Ub~cYbWcbhfciYghiXcgWcafYgi`hUXcg
dcg]h]jcggcVfYcUggibhc"

MEDICINA

ANTROPOSFICA
?]Yb`YY?]YbY&$%$diV`]WUfUafYj]g~cg]ghYazh]WU
XYYghiXcgW`b]WcgWcbhfc`UXcggcVfYcigcXYYlhfUhcg
XYJ]gWiaU`Via iaaYX]WUaYbhcUbhfcdcgWc bU
eiU`]XUXYXYj]XUXYdUW]YbhYgWcaW|bWYf"BcjYYghiXcg
Wcbhfc`UXcg Y fUbXca]nUXcg acghfUfUa eiY c igc
XYggYaYX]WUaYbhcXifUbhYchfUhUaYbhccbWc`[]Wc
WcbjYbW]cbU` ei]a]chYfUd]U  fUX]chYfUd]U  W]fif[]U
hfcilY VYbYZW]c YghUh]gh]WUaYbhY g][b]Z]WUbhY bU
fYXi~cXYbzigYUg6gg]b[YhU`" &$$,/D]UcYhU`" &$$(/
GW\iaUW\Yf Yh U`"  &$$'  ja]hcg 6cW_ Yh U`"  &$$(
Y UaVcg cg g]bhcaUg Hf[YfYh U`"  &$$-/ GYa][`Ugcj
Yh U`"  &$$*/ @cYkY!AYgW\ Yh U`"  &$$,/ AUhh\Yg Yh U`" 
&$$+/:f]YXY`YhU`" &$$-"IaYghiXcacghfciUdYbUg
hYbXbW]Udcg]h]jUGYa][`UgcjYhU`" &$$( Ycihfcb~c
acghfciVYbYZW]c<Y]bmYhU`" %--,"5gVUgYgXYXUXcg
dYgei]gUXUg ZcfUa 5A98  6]cg]g DfYj]Ykg  75AVUgY 
7cW\fUbY@]VfUfm 9aVUgY A98@=B9#DfYA98@=B9 B@A
;UhYkUmYVUgYgXYXUXcgdUfh]Wi`UfYg"
7Uf`ggcb Yh U`" &$$* diV`]WUfUa YghiXc gcVfY U
dYfWYd~c XY eiU`]XUXY XY j]XU Y gUh]gZU~c Ya Xc]g
[fidcgXYai`\YfYgWcaW|bWYfXYaUaUB1%&$ 
hfUhUXUgWcahYfUd]UgUbhfcdcgWUgaYX]WUaYbhcg
UbhfcdcgZ]Wcg ]bW`i]bXc J]gWia U`Via  X]YhU  UfhY
hYfUd]U Yiff]ha]U aUggU[YahYfUdih]WUY\]XfchYfUd]U

Pa l i a t i v o s

2 011;

(3)

S u p l e m e n t o

)'

)'((

:fej\ejf9iXj`c\`if[\E}lj\Xj\Md`kfj

:fej\ejf9iXj`c\`if[\E}lj\Xj\Md`kfj

SUPLEMENTO2
fYXi~cg][b]WUh]jUbUgYjYf]XUXYXYbzigYUgYja]hcg 
XifU~cXYbzigYUgYZfYeibW]UXYja]hcg"
C cihfc YghiXc 8]VV`Y Yh U`"  &$$$  ]bW`i]i %+
ai`\YfYgYahfUhUaYbhcei]a]chYfzd]WcdUfUW|bWYf
XY aUaU X]j]X]XUg Ya [fidc Wcbhfc`Y Wi]XUXcg
\UV]hiU]gY[fidceiYZc]hfY]bUXcdUfUUihcUd`]WU~c
XY UWidfYgg~c V]`UhYfU` bcg dcbhcg D* Y GH'* :]["
*" <cijY X]ZYfYbU g][b]Z]WUbhY ZUjcfzjY` Uc [fidc
UWidfYgg~ceiYfY`UhciaYbcgYjYbhcgXYbzigYUD0
$ $%YaYbcf]bhYbg]XUXYXYbzigYUD0$ $(XifUbhY
cgXYndf]aY]fcgX]UgXYei]a]chYfUd]U"

XYbzigYUYja]hcYhYjYaYbcfbYWYgg]XUXYXYXfc[Ug
Ubh]Yah]WUgYUbU`[g]WUg"
GU``YfYhU`"%-,* UcUd`]WUfYaUH9BGYaUggcW]U~c
WcaaYhcW`cdfUa]XUbUdfYjYb~cXYbzigYUgYja]hcg
YadUW]YbhYggiVaYh]Xcg{UbYghYg]U[YfU` cVgYfjUfUa
eiY c YZY]hc Ubh]Yah]Wc XYggY aYX]WUaYbhc Zc]
UiaYbhUXc WcacWcbgYeibW]Uc]bhYfjU`cXUgXcgYg
Zc] U`Uf[UXc Y U cWcffbW]U XY bzigYUg Y ja]hcg Zc]
X]a]biXU"CYgWcfYXYbzigYUgYja]hcg Ugg]aWcac
UZfYeibW]UXYih]`]nU~cXYUbh]Yah]WcgYUbU`[g]Wcg
UX]W]cbU]ghUaVaZcfUaaYbcfYg Wcag][b]W|bW]U
YghUhgh]WU bc[fidceiYih]`]nciUH9BG"
NUfUhY Yh U`" &$$% WcadUfUfUa U Ud`]WU~c XY
H9BG{hYfUd]Ud`UWYVcYa&&%dUW]YbhYgbcdYfcXc
dg!cdYfUhf]c XY Wc`YW]ghYWhca]U `UdUfcgWd]WU
Y`Yh]jUYcVgYfjUfUaiaUX]a]bi]~cg][b]WUbhYbU
]bW]XbW]UXYbzigYUgYja]hcgbc[fidcXYih]`]nci
UH9BGD0$ $)"
5c WcadUfUf U U~c Ubh]Yah]WU XU H9BG { XU
cbXUbgYhfcbU Ya dUW]YbhYg giVaYh]Xcg { W]fif[]U
`UdUfcgWd]WU  7c`caU Y Wc`UVcfUXcfYg &$$& b~c
Yj]XYbW]UfUaX]ZYfYbUYghUhgh]WUg][b]WUbhYYbhfYUg
XiUghYfUd]Ug XYacbghfUbXceiYUH9BGdcXYf]UgYf
iaUU`hYfbUh]jUYWUnUYggYaYX]WUaYbhcbUdfYjYb~c
XYbzigYUgYja]hcg"

ACUPUNTURA

9nncYhU`"&$%$gY`YW]cbUfUaYghiXcgfUbXca]nUXcg
XY UWidibhifU dcf U[i`\U  Y`hf]Wc  aU[bYhcg 
ci UWidfYgg~c dUfU bzigYUg Y ja]hcg ]bXin]Xcg
dcf ei]a]chYfUd]U" CbnY YghiXcg B 1 %&(+ ZcfUa
YbWcbhfUXcg8]VV`Y YhU`" &$$$/8ibXYY YhU`" %-,+/
8ibXYYYhU`" %-,,/AWa]``UbYhU`" %--%/Bc[UYhU`" 
&$$&/ DYUf`  %---/ FcgWcY Yh U`"  &$$&/ FcgWcY Yh U`" 
&$$'/G\Yb &$$$/GhfY]hVYf[YfYhU`" &$$'/HfY]g\YhU`" 
&$$'"5dgUbz`]gY[`cVU` UYgh]ai`U~cbcgdcbhcg
XYUWidibhifUdcfhcXUgUgacXU`]XUXYggidfUW]hUXUg
fYXin]i U ]bW]XbW]U XY ja]hc U[iXc D 1 $ $( 
aUg b~c XY bzigYU U[iXU ci hUfX]U WcadUfUXcg Uc
Wcbhfc`Y"DcfacXU`]XUXY UUWidibhifUWcaU[i`\Ug
fYXin]ija]hcU[iXcD1$ $% aUgb~cUgYjYf]XUXY
XU bzigYU U[iXU" 9`YhfcUWidibhifU fYXin]i ja]hc
U[iXcD1$ $&/UWidfYgg~cfYXin]iUgYjYf]XUXYaX]U
XY bzigYU U[iXU D 1 $ $(  aUg b~c ja]hc U[iXc
ci g]bhcaUg hUfX]cg" 9`YhfcYgh]ai`U~c b~c ]bjUg]jU
b~c acghfci VYbYZW]cg" HcXcg cg YghiXcg igUfUa
WcbWca]hUbhYaYbhYUbh]Yah]Wcg"
9aYghiXcfYU`]nUXcdcf7\ccYhU`"&$$*ZcfUa
fYU`]nUXUggYggYgXYY`YhfcUWidibhifUXY'$a]bihcg
Wca ZfYeibW]U XY %$ <n Y XifU~c XY di`gc XY
%,$ a]WfcgY[ibXcg Wca &+ dUW]YbhYg  acghfUbXc
g][b]Z]WUh]jU fYXi~c Xcg g]bhcaUg Ya -* ' Xcg
dUW]YbhYg gYbXceiY'+aUbh]jYfUa!gYgYaja]hcg
Udg U ]bhYfjYb~c" 9ghY YghiXc b~c Wcbh]b\U iaU
]bhYfjYb~cd`UWYVccgdUW]YbhYgZcfUaWcadUfUXcg
UcgYighUhigdf!hfUhUaYbhc"
9a fY`U~c { UWidfYgg~c  ZcfUa fYU`]nUXcg
Xc]g YghiXcg W`b]Wcg Wca dUW]YbhYg Ya UaV]YbhY
XY \cgd]WY 6fckb Yh U`"  %--&/ DYf_]bg  Jck`Yf 
&$$,  Wca dYeiYbc baYfc dUfh]W]dUbhYg c]hc
Y XYn  fYgdYWh]jUaYbhY gYa gY ]XYbh]Z]WUf YZY]hcg
g][b]WUh]jcgXU]bhYfjYb~c"
AmYfgYhU`"&$$, YafYj]g~cXU`]hYfUhifUaX]WU 
YbWcbhfUfUaXc]gYghiXcgfUbXca]nUXcgeiYacghfUfUa
VYbYZW]cXUUWidfYgg~cYhUaVaXUaUggU[YagiYWU
bcU`j]cXYbzigYUgYja]hcgYafY`U~cUcg[fidcg
Wcbhfc`Y"9aiaXYggYgYghiXcg G\]bYWc`UVcfUXcfYg
&$$( YghiXUfUa () dUW]YbhYg bc dg!cdYfUhf]c
XY W|bWYf [zghf]Wc fYWYVYbXc c df]aY]fc W]W`c XY
ei]a]chYfUd]UWcaW]gd`Uh]bUY)!icfcifUW]` X]j]X]Xcg
YbhfY [fidc Wcbhfc`Y Y [fidc ]bhYfjYb~c" 5aVcg
fYWYVYfUaaYX]WU~cUbh]Yah]WU\UV]hiU`"C[fidc
]bhYfjYb~cfYWYVYihfY]bUaYbhcdUfUUWidfYgg~c gYbXc
cf]YbhUXcUZUnYfdfYgg~cX][]hU`dcfW]bWca]bihcgbc
dcbhcD*`cWU`]nUXchfgXYXcgUVU]lcXUdf]aY]fUdfY[U
dU`aUfYbhfYcghYbXYgdU`aUf`cb[cYYlcffUX]U`
XcWUfdc:][") UcaYbcghfgjYnYgUcX]UUbhYgXU
ei]a]chYfUd]UY{gfYZY]YggYbYWYggzf]c"CbX]WYXY
F\cXYZc]igUXcdUfUUjU`]U~c"C[fidc]bhYfjYb~chYjY
B r a s i l e i r a

)(

SUPLEMENTO 2

hcXUgdfYgWf]hUgdcfaX]WcUX]W]cbUXUgUchfUhUaYbhc
WcbjYbW]cbU`ciUdYbUghYfUd]UWcbjYbW]cbU`"CgXUXcg
XUUXa]gg~c UdgiaYW]bWcUbcgZcfUaUbU`]gUXcg"
:cfUaigUXcgcgeiYgh]cbzf]cg9CFH7E@E!7'$YXY
gUh]gZU~cXYj]XU"DUfUgYhYYgWU`Ug]bW`i]bXcbzigYUg
Yja]hcg\cijYgidYf]cf]XUXYXc[fidceiYfYWYVYi
hfUhUaYbhc UbhfcdcgZ]Wc UX]W]cbU`  Y dUfU cihfUg
eiUhfcYgWU`UggidYf]cf]XUXYXc[fidcWcbjYbW]cbU`"
9a\cgd]hU`UbhfcdcgWcbUGiU <YiggYfYhU`"
&$$*cVgYfjUfUaU]bibW]UXchfUhUaYbhcdU`]Uh]jc
bU eiU`]XUXY XY j]XU XY %(( dUW]YbhYg Wca W|bWYf
UjUbUXc" Cg eiYgh]cbzf]cg 9CFH7 E@E!7'$  <58G
Y G9@H!A ZcfUa Ud`]WUXcg bU UXa]gg~c  U`hU Y Udg
eiUhfcaYgYg"ChfUhUaYbhc]bW`iUaYX]WUaYbhcgXY
gidcfhYdfYZYfYbW]U`aYbhYUbhfcdcgWcg Yif]ha]U
hYfUd]UdY`cacj]aYbhc dg]WchYfUd]U UfhYhYfUd]UYa
[fidc X]YhUYfYdcigcUXYeiUXc"AY`\cfUbUeiU`]XUXY
XY j]XU Zc] j]ghU bUg j]bhY X]aYbgYg dYgei]gUXUg
Udg c hfUhUaYbhc  XcnY XUg eiU]g YghUh]gh]WUaYbhY
g][b]WUbhYgbzigYUgYja]hcg.D1$ $)*"

Re v i s t a

)'((

d e

C u i d a d o s

HIPNOSE, RELAXAMENTO
(GUIDED IMAGERY)

:][ifU)"DcbhcD*dUfUUWidfYgg~c"

ESTIMULAO

ELTRICA NERVOSA
TRANSCUTNEA (TENS)
8YbhfY cg hfUhUaYbhcg b~c ZUfaUWc`[]Wcg dUfU
bzigYUgYja]hcg YbWcbhfU!gYUYgh]ai`U~cY`hf]WU
bYfjcgU hfUbgWih|bYU H9BG eiY dcXY Uil]`]Uf bU
fYXi~cXYghYgg]bhcaUgDigW\YhU`" &$$$"
Dcghi`U!gYeiYUH9BGUhiYbcg]ghYaUYlhfUd]fUa]XU` 
UhfUjg Xc UiaYbhc XUg YbXcfbUg  YbWYZU`]bUg ci
UaVcg  \]dhYgY Udc]UXU dcf U`[ibg YghiXcg eiY
V`ceiYUfUacYZY]hcUbh]Yah]WcXUH9BGUhfUjgXU
bU`clcbUDigW\YhU`" &$$$/@YY8cbY %---/GU``Yf
YhU`" %-,*"GU``YfYWc`UVcfUXcfYg%-,*dfcdigYfUa
U]bXUeiYbYifcdYdhXYcgYbX[YbcgYaYWUb]gacg
gYfchcb]bf[]Wcg dcXYa YghUf Ybjc`j]Xcg bc YZY]hc
Ubh]Yah]Wc XU H9BG XYj]Xc Uc gYi ]adUWhc gcVfY U
Uh]j]XUXY[Ughfc]bhYgh]bU`"
DigW\ Y Wc`UVcfUXcfYg &$$$ Ud`]WUfUa H9BG
Ya dUW]YbhYg giVaYh]XUg { W]fif[]U []bYWc`[]WU
Y YbWcbhfUfUa iaU X]a]bi]~c g][b]Z]WUh]jU bU
ZfYeibW]U XU gYbgU~c XY bzigYUg Y ja]hcg" H9BG
hUaVa Zc] Ud`]WUXU Wca giWYggc Ya dUW]YbhYg
giVaYh]Xcg { Wc`YW]ghYWhca]U j]XYc`UdUfcgWd]WU
Y`Yh]jU" 8ifUbhY Ug df]aY]fUg gY]g \cfUg XY dg!
cdYfUhf]c  c [fidc eiY ih]`]nci U H9BG UdfYgYbhci
jU`cfYgaYbcfYgXYdcbhiU~cbUYgWU`UXYUjU`]U~c

2 011;

(3)

S u p l e m e n t o

VISUALIZAO

9bhfYUg]bhYfjYbYg]bX]WUXUgdUfUcWcbhfc`YXY
g]bhcaUg  YgdYW]WUaYbhY  bzigYUg Y ja]hcg  Ygh~c
c fY`UlUaYbhc  U j]giU`]nU~c Y U \]dbcgY" 9ghUg  bc
WYbzf]c XY Wi]XUXcg dU`]Uh]jcg  YbeiUXfUa!gY bU
dg]WchYfUd]UVfYjYXYUdc]ceiYcV^Yh]jUfzUUVigWU
XYYei]`Vf]c\caYcghzh]WceiYgYYldfYggUbcU`j]c
XYg]bhcaUg9`]Ug &$$*"
9adg]Wc!cbWc`c[]U Yl]ghYaYghiXcgUdcbhUbXcU
YZYh]j]XUXYXU\]dbchYfUd]UUggcW]UXUUcfY`UlUaYbhc
Yj]giU`]nU~cdUfUWcbhfc`YXYbzigYUYja]hcXifUbhY
Uei]a]chYfUd]UciYadUW]YbhYghfUbgd`UbhUXcgHif_
:Y`XaUb &$$-/@ch!>UaYhU`" &$$, F]W\UfXgcbYh
U`" &$$*/<c``UbX %--,/Gmf^U`UYhU`" %--&/Gmf^U`UYh
U`" %--)/AcffckYhU`" %--,"
GcVfY c YZY]hc XY hWb]WUg XY fY`UlUaYbhc dUfU
c U`j]c XY bzigYUg Y ja]hcg  Ya %$ XY %' YghiXcg
Ac`Ugg]ch]g Yh U`"  &$$$/ 7chUbW\  Ghfia  %-,+/
@m`Yg Yh U`"  %-,&/ Acffck  %-,*/Acffck Yh U`" %--&/
6]``\i`h Yh U`" &$$+/6if]g\ Yh U`" %-,+/6if]g\ 
>Yb_]bg %--&/6if]g\ Yh U`"  %--'/ JUghYf`]b[ Yh U`" 
%--' Ybjc`jYbXciahchU`XY)($dUW]YbhYgUXi`hcg
Y Wf]UbUg  YbWcbhfUfUa fYgi`hUXcg dcg]h]jcg Y Wca
X]ZYfYbU YghUh]gh]WUaYbhY g][b]Z]WUbhY  hUbhc bU
]bW]XbW]U XY bzigYUg UbhYW]dUhf]U VYa Wcac bU
[fUj]XUXYXUgbzigYUgYja]hcg"
CYghiXcXY5\`YgYhU`"%---acghfcieiYc[fidcXY
dUW]YbhYggiVaYh]XcgUhfUbgd`UbhYUih`c[cXYaYXi`U
ggYUeiYfYWYVYiaUggU[YagiYWUhYjYg][b]WUbhYaYbhY
aYbcgbzigYUeiYc[fidcWcbhfc`Y gY[i]bXc{df]aY]fU
aUggU[Ya%-XYfYXi~c D1$ $%"
;fYU`]g\YhU`"&$$$ YaUacghfUXY,+dUW]YbhYg
cbWc`[]Wcg\cgd]hU`]nUXcg acghfUfUaeiYUdgXYn
a]bihcg XY aUggU[Ya bcg dg \Uj]U YZY]hc ]aYX]Uhc
bU dYfWYd~c XY Xcf  bzigYU Y fY`UlUaYbhc  igUbXc
YgWU`Uj]giU`UbU`[]WU"5fYXi~c]aYX]UhUXUbzigYU
Zc]g][b]WUbhYD1$ $$%"
Hf]bhUYbcjYai`\YfYgYahfUhUaYbhcei]a]chYfzd]Wc
dUfU W|bWYf XY aUaU dUfh]W]dUfUa XY YghiXc
fUbXca]nUXc Y Wcbhfc`UXc 6]``\i`h Yh U`"  &$$+ 
Yj]XYbW]UbXceiYUaUggU[YafYXin]ig][b]WUbhYaYbhY
UbzigYUWcadUfUXUUc[fidcWcbhfc`YD1$ $&)Udg
W]bWcdYfcXcgXYhfUhUaYbhc"
9a &$$*  F]W\UfXgcb Yh U`" diV`]WUfUa fYj]g~c
g]ghYazh]WUgcVfY\]dbcgYdUfUbzigYUgYja]hcgYa
ei]a]chYfUd]UdUfUcW|bWYf dYgei]gUbXcUgVUgYgXY
XUXcgAYX`]bY 9aVUgY 7]bU\` DgmW=B:CY7cW\fUbY

:][ifU*"DcbhcGH*dUfUUWidfYgg~c"

Pa l i a t i v o s

Re v i s t a

B r a s i l e i r a

d e

C u i d a d o s

@]VfUfm"GY]gYghiXcgWcbhfc`UXcg W]bWcXcgeiU]gYa
Wf]UbUg XY ) U %, Ubcg ZcfUa ]XYbh]WUXcg  Wca
fYgi`hUXcg g][b]WUbhYaYbhY dcg]h]jcg Ya fY`U~c U
YghU]bhYfjYb~cdUfUbzigYUgUbhYW]dUhf]UgYbzigYUg
Yja]hcg`][UXcg{ei]a]chYfUd]U {YlWY~cXcYghiXc
Ybjc`jYbXcUXi`hcg"
Acbh[caYfm Yh U`" &$%$ fUbXca]nUfUa &$$
dUW]YbhYg giVaYh]XUg { W]fif[]U aUazf]U dUfU
fYWYVYfYa bc df!cdYfUhf]c \]dbcgY ci hYfUd]U XY
gidcfhY Wcac [fidc Wcbhfc`Y" C [fidc hfUhUXc Wca
\]dbchYfUd]UhYjYaYbcgbzigYUdg!W]ff[]WU aYgac
UdgcWcbhfc`YXUgjUf]zjY]gXYYldYWhUh]jUXYbzigYU
YUb[gh]Udf!cdYfUhf]UgD0$ $$$%"
BYagYadfYdcggjY`Ud`]WUf\]dbcgY fY`UlUaYbhc
Y j]giU`]nU~c bc WcbhYlhc Xcg Wi]XUXcg dU`]Uh]jcg
Hif_:Y`XaUb &$$- YgdYW]U`aYbhYdUfUdUW]YbhYg
WcaXcfU[iXU UghYb]U]bhYbgUYdfY^incgWc[b]h]jcg
]adcfhUbhYg"vXYgY^zjY`eiY\U^UiajbWi`chYfUdih]Wc
dfj]c {g g]hiUYg XY Wf]gY  dc]g ]ggc UiaYbhU giUg
W\UbWYgXYYWzW]U"

AROMOTERAPIA

5fcachYfUd]U  iaU dfzh]WU Wcad`YaYbhUf


eiY ih]`]nU `Ycg YggYbW]U]g XY d`UbhUg Ufcazh]WUg 
]gc`UXUaYbhYciYaUggcW]U~cUaUggU[Ybg"
9a XiUg fYj]gYg XU `]hYfUhifU aX]WU AmYfg Yh
U`"  &$$,/ :Y``ckYg Yh U`"  &$%$  ZcfUa YbWcbhfUXcg
Xc]gYghiXcgfUbXca]nUXcg Wca&,,Y)&dUW]YbhYg 
gYa gY XYacghfUf VYbYZW]c XU aUggU[Ya UggcW]UXU
{ UfcachYfUd]U Ya fY`U~c Ucg [fidcg Wcbhfc`Y bU
fYXi~cXYbzigYUgYja]hcg"

IOGA

5 ]c[U Ybjc`jY hWb]WUg XY fYXi~c Xc YghfYggY


eiY ]bW`iYa YlYfWW]cg XY fY[i`U~c XU fYgd]fU~c 
dcghifUgYlYWihUXUgWcadYfaUbbW]UYfY`UlUaYbhc 
j]giU`]nU~cXY]aU[Ybg fY`UlUaYbhcYaYX]hU~cGcihc 
%--,"DcfgYigYZY]hcgg]c`[]WcghU]ghWb]WUghag]Xc
UXchUXUgWcachYfUd]UWcad`YaYbhUfbchfUhUaYbhcXY
]baYfUgXcYbUg;\UfchY;\UfchY %---"
9ghUXcgXYWcbhfUhifUaigWi`UfYfYgd]fU~cfzd]XU
YgidYfW]U`fYYhYaiaUWcbX]~cU[]hUXUXUaYbhY
HU]ab] %--*YXYbchUaUdfYgYbUXYYghfYggYZg]Wc
YYacW]cbU` ceiU`UWcadUb\UciZUhcfU[fUjUbhY
XY ]baYfUg WcbX]Yg W`b]WUg" Cg g]bhcaUg aU]g
ZfYeiYbhYg XY dUW]YbhYg Ya Wi]XUXcg dU`]Uh]jcg 
]bW`i]bXcbzigYUgYja]hcg g~c ai]hUgjYnYg [YfUXcg
ciWcad`]WUXcgdY`UdfYgYbUXcYghfYggY"5gg]a iaU
hWb]WU eiY dfcacjU c Wcbhfc`Y ci X]a]bi]~c Xc
YghfYggYgYf]Uh]`bYghUg]hiU~c"
AW8cbU`XYhU`"&$$*]bhfcXin]fUaiadfc^Yhc
d]`chc XY %& gYaUbUg Ya ib]XUXY XY Wi]XUXcg
dU`]Uh]jcg\cgd]hU`!X]U"7cacgiWYggcXUYldYf]bW]U
YadfcacjYffY`UlUaYbhcYUiaYbhUfcVYa!YghUfXY
dUW]YbhYgYWi]XUXcfYg U]c[UZc]]bWcfdcfUXUWcac
dfzh]WUhYfUdih]WUbcgYfj]c"
9afY`U~cUdUW]YbhYgYahfUhUaYbhccbWc`[]Wc 
ZcfUa]XYbh]WUXcgXc]gYbgU]cgfUbXca]nUXcgeiY
gi[YfYaYZY]hcgVYbWcgXYiadfc[fUaUXY]c[U
X]f][]XcUai`\YfYgWcaW|bWYfXYaUaUbcaUbY^c
XUXcYbUYXYg]bhcaUgXYWcffYbhYgXchfUhUaYbhc"
9aiaXcgYbgU]cg dYgei]gUXcfYgWcadUfUfUaia
dfc[fUaU XY ]c[U { hYfUd]U XY gidcfhY VfYjY" DUfU
c[fidcXY]c[U\cijYiaXYWfgW]acg][b]WUh]jc
XU Ub[gh]U dg]Wc`[]WU  ZUX][U  ]bgb]U Y dYfXU
XY UdYh]hY Ya WcadUfU~c Uc Wcbhfc`Y" <z iaU
WcffY`U~cZcfhYaYbhYdcg]h]jUYbhfYUb[gh]UZg]WU
Y dg]Wc`[]WU Y cg g]bhcaUg aU]g ZfYeiYbhYg Ya
Wi]XUXcg dU`]Uh]jcg  Wcac Xcf  ]bgb]U  X]gdbY]U 
ZUX][U bzigYUgYja]hcgJUX]fU^UYhU`" &$$-"
9acihfcYghiXc YlUa]bci!gYcYZY]hcXcaYgac
dfc[fUaUXY]c[UUW]aUW]hUXcYabzigYUgYja]hcg
fY`UW]cbUXcg{ei]a]chYfUd]UYaai`\YfYgcdYfUXUg
dcf W|bWYf XY aUaU" DUfU c [fidc eiY gY[i]i c
Pa l i a t i v o s

2 011;

(3)

S u p l e m e n t o

))

)'((

:fej\ejf9iXj`c\`if[\E}lj\Xj\Md`kfj

:fej\ejf9iXj`c\`if[\E}lj\Xj\Md`kfj

SUPLEMENTO2

ASPECTOS

PSICOSSOCIAIS E INTERVENES
PSICOLGICAS
BzigYUg Y ja]hcg g~c dfcV`YaUg Wcad`Ylcg
YaWi]XUXcgdU`]Uh]jcg dcfYggUfUn~cYl][YaiaU
UVcfXU[Yaai`h]dfcgg]cbU`"5gdYWhcgdg]Wc`[]Wcg
dcXYahYfYZY]hcg]adcfhUbhYggcVfYUgYldYf]bW]Ug
XYbzigYUgYja]hcg UbhYW]dUhf]cgcib~cF\cXYg
AW8Ub]Y` &$$*"
Bcg `cWU]g XY dYfaUbbW]U Xc dUW]YbhY XYjYa
gYf fYXin]Xcg ci Y`]a]bUXcg Yghai`cg bUigYUbhYg 
a]b]a]nUXcg gcbg Y cXcfYg XYgU[fUXzjY]g" 7cac cg
dUW]YbhYg Wca W|bWYf UjUbUXc dcXYa b~c gYbh]f
ZcaYcigYXY giUdfYZYfbW]UcicXYgY^cXYb~cWcaYf
XYjYa gYf fYWcb\YW]Xcg Y fYgdY]hUXcg  dcXYbXc gYf
YWUndUfUiaUdfc`Ul]UYabzigYUgYja]hcgdg!
W]ff[]WcF\cXYgAW8Ub]Y` &$$*"
5`[iaUg ]bhYfjYbYg Wcad`YaYbhUfYg b~c
aYX]WUaYbhcgUgdcXYa YjYbhiU`aYbhY gYfYbg]bUXUg
Uc dfdf]c dUW]YbhY Y UiaYbhUf U giU gYbgU~c XY
Wcbhfc`Y ]biYbW]UbXcUg]bhcaUhc`c[]U"
v]adcfhUbhYhfUhUfUib]XUXYXYWi]XUXcgdUW]YbhY#
ZUa`]U dc]gUUbg]YXUXYXcgZUa]`]UfYgdcXYWUigUf
YlUWYfVU~c Xc eiUXfc g]bhcazh]Wc Xcg dUW]YbhYg
AUW]Y]fU6UfVcgU &$$-"
DciWcgYghiXcghafY`UhUXcc]adUWhcXcgWi]XUXcg
Xca]W]`]UfYg gcVfY cg g]bhcaUg Xc dUW]YbhY Y giUg
WcbgYeibW]Ug gcVfY gYig ZUa]`]UfYg" AYfWUXUbhY Yh
U`"&$$$UjU`]UfUadfcgdYWh]jUaYbhY'+'dUW]YbhYg
WcbgYWih]jcg YbWUa]b\UXcg dUfU c dfc[fUaU XY
Wi]XUXcg dU`]Uh]jcg Xca]W]`]UfYg  gY`YW]cbUXcg dY`U
dfYgYbU XY X]ZYfYbhYg g]bhcaUg Xcf  bzigYUg Y
ja]hcg  VcWU gYWU  X]gZU[]U  XYgWcbZcfhc [zghf]Wc 
Wcbgh]dU~c  X]UffY]U  X]gdbY]U  gcbc`bW]U  ZfUeiYnU 
WcbZig~caYbhU` g]bhcaUgdg]Wc`[]Wcg"8cf bzigYUg
Yja]hcg XYgWcbZcfhc[zghf]WcYX]UffY]UX]a]bifUa
g][b]Z]WUh]jUaYbhY Udg U ]bhYfjYb~c dU`]Uh]jU
]bhY[fU` aYX]WUaYbhcgU  bihf]W]cbU`  dg]WchYfzd]WU
YhW""9ghUaY`\cfUZc]aUbh]XUUhUacfhY YbeiUbhc
U]b[YghU`ei]XUYcWcbgiacU`]aYbhUfX]a]bifUa
g][b]WUh]jUaYbhYXifUbhYcg`h]acgX]UgXYj]XU"
5VigWUdfYWcWY Uh]jUYWcbhbiUXYdUW]YbhYgaU]g
gigWYhjY]g dfYZYfYbW]U`aYbhY UbhYgXcdf]aY]fcW]W`c
Xc hfUhUaYbhc   fYWcaYbXUXU dUfU U dfYjYb~c XY
bzigYUgYja]hcgUbhYW]dUhf]cg UhfUjgXYUbUabYgYg
VYaY`UVcfUXUgWcacgdUW]YbhYgY#ciZUa]`]UfYg"
HUaVa g~c ]bX]WUXUg ]bhYfjYbYg dg]Wc!
YXiWUW]cbU]g XY WUdUW]hU~c Y UWcbgY`\UaYbhc
hYfUdih]Wc dfcZ]`zh]Wcg  Wcac ZcfaU XY cZYfYWYf
]bZcfaUYgYaaUbY^cXYg]bhcaUg"ChfY]bUaYbhc
XY \UV]`]XUXYg hYa Wcac ZcWc c XYgYbjc`j]aYbhc
Xc YbZfYbhUaYbhc  U Wcaib]WU~c Y fYgc`i~c XY
dfcV`YaUg"CUWcbgY`\UaYbhchYfUdih]WcWcbWYbhfU!
gY df]bW]dU`aYbhY bc XYgYbjc`j]aYbhc XU fY`U~c
hYfUdih]WUdUfUhfUhUfXYdfYcWidUYgfY`UW]cbUXUg
WcaUdfdf]UXcYbUBcfh\cigYYhU`" &$%$"
Jzf]cgYghiXcg6U]bYg %--+/:][iYfcU!AcgY`YmYhU`" 
&$$+/C6f]Yb &$$,UdcbhUadUfUU`][U~cXU]bghU`U~c
XY bzigYUg Y ja]hcg Wca U aYaf]U XY YjYbhcg
UbhYf]cfaYbhYdciWcWcbhfc`UXcgXifUbhYchfUhUaYbhc"
DUfU 7fin  8Y` ;][`]c &$%$  U ZU`hU XY Wcbhfc`Y

B r a s i l e i r a

)*

SUPLEMENTO 2

dfc[fUaU XY ]c[U \cijY aY`\cfU g][b]Z]WUh]jU bU


ZfYeibW]UY]bhYbg]XUXYXUgbzigYUgfY`UW]cbUXUg
{ ei]a]chYfUd]U  Y bU ]bhYbg]XUXY XUg bzigYUg Y
ja]hcg UbhYW]dUhf]cg Ya WcadUfU~c Uc [fidc
Wcbhfc`YgiVaYh]XcUiaU]bhYfjYb~cXYhYfUd]U
XY gidcfhY" <cijY WcffY`U~c g][b]Z]WUh]jUaYbhY
dcg]h]jUYbhfYA5B9aYX]XUXYUjU`]U~cXYbzigYUg
Yja]hcgUXchUXUYgWcfYgYg]bhcaUgXYUbg]YXUXY 
XYdfYgg~cYUb[gh]U"9ghYgfYgi`hUXcggi[YfYadUfU
fYXi~c XY YghfYggY c igc XU ]c[U Wcac hYfUd]U
Wcad`YaYbhUf Ucg Ubh]Yah]Wcg WcbjYbW]cbU]g
bc aUbY^c XY bzigYUg Y ja]hcg fY`UW]cbUXcg {
ei]a]chYfUd]UFU[\UjYbXfUYhU`" &$$+"

Re v i s t a

)'((

d e

C u i d a d o s

Ubh]Yah]WcUXYeiUXcU`hYfUcghUhigbihf]W]cbU` h]fU
c dfUnYf XY WcaYf Y VYVYf  X]a]bi] U UXYfbW]U Uc
hfUhUaYbhc U`aXYdcXYfUiaYbhUfgYigWighcg"
5ghYfUd]Ugdg]Wc`[]WUgYWcadcfhUaYbhU]gha
dUdY` ]adcfhUbhY gcVfY cg UgdYWhcg dg]Wc`[]Wcg
Y bYifcZ]g]c`[]Wcg ]ad`]WUXcg bU Yh]c`c[]U Xcg
g]bhcaUg AUfW\]cfc Yh U`"  &$$$/ :][iYfcU!AcgY`Ym
YhU`" &$$+/5_YW\] &$%$"
BzigYUg Y ja]hcg Ya dUW]YbhYg bU ZUgY Z]bU` XY
j]XUdfYW]gUagYfc`\UXcgWcaWi]XUXc"9ghYdYfcXc
WcghiaUgYfai]hcUb[igh]UbhYdUfUcgZUa]`]UfYgeiY
UggcW]UaaUbhYfUj]XUWcaU`]aYbhU~cU]bXUeiY
ZcfUXUXcdUW]YbhY"9ghY UcWcbhfzf]c dfYW]gUXYai]hc
dciWU]b[YghUXYU`]aYbhcgY`ei]Xcg"5gg]a Wf]Ua!gY
g]hiUYgXYWcb]hc YlUigh~cYgcZf]aYbhcdUfUhcXcg
cgaYaVfcgXUib]XUXYXYWi]XUXcg"BYghYacaYbhc 
ceiYhcXcgaU]gbYWYgg]hUaXUYei]dYXYgUXYc
UadUfceiYhfU[UhfUbei]`]XUXYYgYfYb]XUXY"

X]jYfgUgg]hiUYg YXYghUZcfaUaY`\cfUfUeiU`]XUXY
XcgWi]XUXcgXYgidcfhY"
 C YgW`UfYW]aYbhc gcVfY cg jzf]cg [Uh]`\cg eiY
XYgYbWUXY]UabzigYUgYja]hcgdcXY`YjUfUiaU
gf]Y XY YghfUh[]Ug dUfU dfYj]b]f YggY XYgWcbZcfhc
77C &$%$"
5gVifmKU`g\Y&$$)acghfUfUaU]adcfh|bW]U
XY ia Zc`\Yhc ]bZcfaUh]jc WcbWYV]Xc dUfU U^iXUf
dUW]YbhYg Wca W|bWYf XY aUaU U WcadfYYbXYf Y
`]XUfWcabzigYUgYja]hcg"
:]hUgXYziX]chUaVag~cZYffUaYbhUgXYYbg]bc
YZ]WUn" 7cadcfhUaYbhcg XY UihcUhYbX]aYbhc

REFERNCIAS BIBLIOGRFICAS
Aaronson NK, Ahmedzai S, Bergman B et al. The European Organization for Research and Treatment of Cancer QLQ-C30: A Quality-of-Life Instrument
for Use in International Clinical Trials in Oncology. Journal of the National Cancer Institute, 85(5):365-76, 1993.
Ahles TA, Tope DM, Pinkson B, Walch S, Hann D, Whedon M, Dain B, Weiss JE, Mills L, Silbarfarb PM. Massage therapy for patients undergoing
autologous bone marrow transplantation. Journal of Pain & Symptom Management, 18:157-63, 1999.
Akechi T. Essential psychological care in palliative medicine. Seishin Shinkeigaku Zasshi, 112(10):1029-36, 2010.
Alvarez O, Freeman A, Bedros A, Call S K, Volsch J, Kalbermatter O, Halverson J, Convy L et al. Randomized double-blind crossover ondansetron-dexamethasone versus ondansetron-placebo study for the treatment of chemotherapy-induced nausea and vomiting in pediatric patients with malignancies.
J Pediatr Hematol Oncol, 17:145-50, 1995.
ANCP - Academia Nacional de Cuidados Paliativos. Manual de cuidados paliativos. Rio de Janeiro: Diagraphic, 2009. p.117-23. Disponvel em:
<http://www.paliativo.org.br/dl.php?bid=57> Acesso em 05/04/2011.
Antonarakis ES, Evans JL, Heard GF, Noonan LM, Pizer BL, Hain RD. Prophylaxis of acute chemotherapy-induced nausea and vomiting in children with
cancer: what is the evidence? Pediatr Blood Cancer, 43(6):651-8, 2004.
Araujo RCZ, Chalfoun SM, Anglico CL, Araujo JBS, Pereira MC. Avaliao in vitro da atividade fungitxica de extratos de condimentos na inibio
de fungos isolados de pes artesanais. Cincia e Agrotecnologia, 33(2):545-51, 2009.
Asbury N, Walshe A. Involving women with breast cancer in the development of a patient information leaflet for anticipatory nausea and vomiting.
European Journal Oncology Nursing, 9(1):33-43, 2005.
Baines, Mary J. ABC of palliative care: Nausea, vomiting and intestinal obstruction. British Medical Journal, 315(7116):1148-50, 1997.
Basade M, Kulkarni SS, Dhar AK, Sastry PS, Saikia B, Advani SH. Comparison of dexamethasone and metoclopramide as antiemetic in children receiving
cancer chemotherapy. Indian Pediatr, 33(4):321-3, 1996.
Benarroz MO, Faillace GBD, Barbosa LA. Biotica e nutrio em cuidados paliativos oncolgicos em adultos. Cad. Sade Pblica, 25(9):1875-82, 2009.
Bentley A, Boyd K. Use of clinical pictures in the management of nausea and vomiting: a prospective audit. Palliat Med, 15(3):247-53, 2001.
Berrak SG, Ozdemir N, Bakirci N, TurKKan E, Canpolat C, Beker B, Yoruk A. A double blind, crossover, randomized dose comparison trial of granisetron for the prevention of acute and delayed nausea and emesis in children receiving moderately carboplatin-based chemotherapy. Support Care
Cancer, 15(10):1163-8, 2007.
Billhult A, Bergbom I, Stener-Victorin E. Massage relieves nausea in women with breast cancer who are undergoing chemotherapy. J Altern Complement
Med, 13(1):53-7, 2007.
Bock PR, Friedel WE, Hanisch J, Karasmann M, Schneider B. Efficacy and safety of longterm complementary treatment with standardised European
Mistletoe extract (Viscum album L.) in addition to the conventional adjuvant oncological therapy in patients with primary non-metastatic breast cancer.
Arzneim Forsch Drug Res, 54(8):456-66, 2004.
Boyd K. Palliative Care Guidelines: Bowel Obstruction, 2008. Disponvel em <www.nhslothian.scot.nhs.uk/ourservices/palliative/documents/bowel_obstruction.pdf> Acesso em 01/05/2011.
Brock P, Brichard B, Rechnitzer C, Langeveld NE, Lanning M, Sodrhall S, Laurent C. An increased loading dose of ondansetron: a north european
double-blind randomized study in children, comparing 5mg/m with 10mg/m. Eur J Cancer, 32A(10):1744-8, 1996.
Brown S, North D, Marvel MK, Fons R. Acupressure wrist bands to relieve nausea and vomiting in hospice patients: Do they work? American Journal of
Hospice and Palliative Medicine, 9(4): 1992. Disponvel em <http://ajh.sagepub.com/content/9/4/26.abstract> Acesso em 01/04/2011.
Bruera E, Kuehn N, Miller MJ, Selmser P, Macmillan K. The Edmonton Symptom Assessment System (ESAS): a simple method of the assessment of
palliative care patients. Journal of Palliative Care, 7(2):6-9, 1991.
Burish TG, Carey MP, Krozely MG, et al. Conditioned side effects induced by cancer chemotherapy: Prevention through behavioral treatment. J Consult
Clin Psychol, 55(1):42-8, 1987.
Burish TG, Jenkins RA. Effectiveness of biofeedback and relaxation training in reducing the side effects of cancer chemotherapy. Health Psychol, 11(1):17-23, 1992.
Burish TG, Snyder SL, Jenkins RA. Preparing patients for cancer chemotherapy: Effect of coping, preparation and relaxation interventions. J Consult
Clin Psychol, 59(4):518-25, 1991.
Bssing A, Brckner U, Enser-Weis U, et al. Modulation of chemotherapy-associated immunosuppression by intravenous application of Viscum album L.
extract (Iscador): a randomized physe II study. Eur J Integr Med, 1(suppl 1):S44-54, 2008.
Carlsson M, Arman M, Backman M, Flatters U, Hatschek T, Hamrin E. A Five-year Follow-up of Quality of Life in Women with Breast Cancer in Anthroposophic and Conventional Care. Evid Based Complement Alternat Med, 3(4):523-31, 2006.
Casuccio A, Mercadante S, Fulfaro F. Treatment strategies for cancer patients with breakthrough pain. Expert Opinion in Pharmacotherapy, 10(6):
947-53, 2009. Disponvel em: <http://www.ncbi.nlm.nih.gov/pubmed/19351277> Acesso em 01/04/2011.
CCO Cancer Care Ontario. Symptom Management. Pocket Guides: Nausea & Vomiting, CCO, 2010. 11 p. Disponvel em <http://cancercare.
on.ca/common/pages/UserFile.aspx?fileId=77290> Acesso em 21/02/2011.
Chaiyakunapruk N, Kitikannakorn N, Nathisuwan S, Leeprakobboon K, Leelasettagool C, The efficacy of ginger for the prevention of postoperative
nausea and vomiting: a meta-analysis. American Journal of Obstetrics and Gynecology. 194(1):95-9, 2006.
Cherny NI. Taking care of the terminally ill cancer patient: management of gastrointestinal symptoms in patients with advanced cancer. Annals of
Oncology, 15(Suppl. 4): iv205-13, 2004.
Chiba T. Sintomas Digestivos. In: Cuidado Paliativo / Coordenao Institucional de Reinaldo Ayer de Oliveira. So Paulo: Conselho Regional de
Medicina do Estado de So Paulo, 2008. p. 424-5.
Choo S-P, Kong K-H, Lim W-T, Gao F, Chua K, Leong S-S. Electroacupuncture for refractory acute emesis caused by chemotherapy. Journal of Alternative
and Complementary Medicine, 12(10):963-9, 2006.
Cline D. Nutrition issues and tools for palliative care. Home Healthcare Nurse, 24(1):54-7, 2006.

ASPECTOS

PSICOSSOCIAIS E INTERVENES
PSICOLGICAS EM PEDIATRIA
BzigYU Y ja]hc dcXYa dfcacjYf ia ]adUWhc
YacW]cbU` bU ZUa`]U Wca ia UiaYbhc XU Ub[gh]U
X]UbhYXYU`[ceiYYW`cXYbcWcfdcXUWf]UbUYeiY
dfcacjY [fUbXYg ]bWacXcg" HUaVa dcXYa gYf
WcbgYeibW]UXYUgdYWhcgXUgiV^Yh]j]XUXYXcdUW]YbhY 
eiUbXc g~c XYWcffYbhYg XY XYgcfXYbg dgei]WUg
UbhYf]cfYgUcgUgdYWhcggcaYbhYcf[|b]Wcg"
Cgg]bhcaUgXYbzigYUYja]hcg~cWcbg]XYfUXcgbU
`]hYfUhifUXUdg]ei]Uhf]UWcaciaXcgWcadcfhUaYbhcg
eiYdcXYagYfXYf]jUXcgXYeiUXfcgXYhfUbghcfbcgXY
Ubg]YXUXY"DUW]YbhYgaU]gUbg]cgcghYbXYaUhYfaU]cf
baYfcXYYd]gX]cgXYbzigYUgYja]hcg"
DUfU @i]g] %--) dU]g Ubg]cgcg dcXYa ZUjcfYWYf
c gif[]aYbhc XY hU]g g]bhcaUg Ya Wf]UbUg Y
UXc`YgWYbhYgYahfUhUaYbhcei]a]chYfzd]Wc YUfaU
U]bXUeiYWf]UbUgaYbcfYgeiYW]bWcUbcgjca]hUa
aU]geiYUXi`hcg"
BU dfzh]WU W`b]WU  YggYg g]bhcaUg dcXYa gYf
]bX]WUXcfYgXYU`[caU]gWcad`YlceiYiaUfYU~c
XYUbg]YXUXYZfYbhYUchfUhUaYbhc hUbhcdcfdUfhYXc
dUW]YbhYeiUbhcXUZUa`]U"
9bhYbXYacgeiYUg]bhYfjYbYgbU]bZ|bW]UdUggUa
gYadfYdY`UgiV^Yh]j]XUXYXcgdU]g"5gWf]UbUgfYgdcbXYa
X]fYhUaYbhYUcgUgdYWhcgYacW]cbU]gXYgYigdU]gYYagY
hfUhUbXcXYg]bhcaUgXYUbg]YXUXY b~c\zWcacWcbXin]f
ia hfUVU`\c eiY b~c dUggY dY`c UWcadUb\UaYbhc
dg]Wc`[]WcXcgdU]gY#ciWi]XUXcfYg"
>zWcacgUXc`YgWYbhYg XYjY!gYUjU`]UfgiUdcg]~c
Y XY giU ZUa`]U Ya giU \]ghf]U dUfh]Wi`Uf]nUXU Y U
fYdfYgYbhU~cXcgg]bhcaUgcf[|b]WcgdUfUWUXUWUgc"
5g]bhYfjYbYghYbhUf~cZUjcfYWYfcXYgYbjc`j]aYbhc
XU UXc`YgWbW]U ]bhYffcad]XU dY`c UXcYW]aYbhc Y
gYi hfUhUaYbhc  Ugg]a Wcac ZUjcfYWYf c dfcWYggc
XY ]bXYdYbXbW]U Y Uihcbca]U Xc UXc`YgWYbhY
ZfYbhY Uc acaYbhc Ya eiY bYWYgg]hU ZUnYf YgWc`\Ug
Y bcjcg dcg]W]cbUaYbhcg bU j]XU eiY c X]ZYfYbW]Ya
XU ZUgY Xc ]bZUbh]`" 9ggUg ]bhYfjYbYg ai]hUg jYnYg
]bW`i]f~ccf]YbhUYgUcgdU]g dcfjYnYgUhYbX]aYbhcg
]bX]j]XiU`]nUXcgWcacgUXc`YgWYbhYgY]bhYfjYbYg
^ibhc{Yei]dYai`h]dfcgg]cbU`"
C hfUVU`\c ]bhYfX]gW]d`]bUf  ZibXUaYbhU` dUfU c
dg]W`c[c"5X]gWigg~cXcWUgcXYjYZUnYfdUfhYXUUjU`]U~c
^ibhcUcfYghUbhYXUYei]dY"5`aX]ggc hUaVadUdY`
Xcdg]W`c[c UdUfh]fXUgiU`Y]hifUYWcadfYYbg~cXcg
UgdYWhcggiV^Yh]jcgXcWUgc dfcdcfYghfUh[]Ug{Yei]dY
eiYZUW]`]hYachfUVU`\cXc[fidcbUUhiU~cWcacg
g]bhcaUgYacW]cbU]gXYWUXUdUW]YbhYYgiUZUa`]U"

PROGRAMAS

EDUCATIVOS, EDUCAO E
ACONSELHAMENTO
Cg dfc[fUaUg YXiWUh]jcg g~c [YfU`aYbhY
X]fYW]cbUXcg dUfU dUW]YbhYg Y ZUa]`]UfYg j]gUbXc
ZcfbYWYf]bZcfaUYgYdfcacjYfYbhYbX]aYbhcgcVfY

Pa l i a t i v o s

2 011;

(3)

S u p l e m e n t o

dcXYa gYf Ybg]bUXcg Y dcXYa gYf YZ]WUnYg bc


aUbY^cXYggYgg]bhcaUg"
Cgg]bhcaUgX]a]bi]fUabUgai`\YfYgeiYfYWYVYfUa
hUgXYziX]cYW\UaUXUghY`YZb]WUg dc]gUUbg]YXUXY
YaUaV]YbhYgW`b]Wcg]bhYfZYfYWcaUUdfYbX]nU[Ya
XcdUW]YbhYK]``]UagGW\fY]Yf &$$("
7Ufh]`\UgWca]bZcfaUYggcVfYUei]a]chYfUd]U 
YZY]hcg Wc`UhYfU]g  hfUhUaYbhcg b~c ZUfaUWc`[]Wcg 
UYg XY UihcWi]XUXcg  bihf]~c Y YlYfWW]cg XY
fY`UlUaYbhcg~cYWUnYgYUiaYbhUaUUihcbca]UY
eiU`]XUXYXYj]XUXcgdUW]YbhYgK]``]UagGW\fY]Yf 
&$$(/>U\bYhU`" &$$-"

Re v i s t a

B r a s i l e i r a

d e

C u i d a d o s

Pa l i a t i v o s

2 011;

(3)

S u p l e m e n t o

)+

)'((

:fej\ejf9iXj`c\`if[\E}lj\Xj\Md`kfj

:fej\ejf9iXj`c\`if[\E}lj\Xj\Md`kfj

SUPLEMENTO2

Re v i s t a

),

SUPLEMENTO 2

Coloma M, White PF, Ogunnaike BO et al. Comparison of acustimulation and ondansetron for the treatment of established postoperative nausea and
vomiting. Anesthesiology, 97(6):1387-92, 2002.
Corapcioglu F, Sarper N. A prospective randomized trial of the emetic efficacy and cost-effectiveness of intravenous and orally disintegrating tablet of
ondansetron in children with cancer. Pediatr Hematol Oncol, 22(2):103-14, 2005.
Cotanch PH, Strum S. Progressive muscle relaxation as antiemetic therapy for cancer patients. Oncol Nurs Forum, 14(1):33-7, 1987.
CREMESP - Conselho Regional de Medicina do Estado de So Paulo. Cuidado Paliativo / Coordenao Institucional de Reinaldo Ayer de Oliveira.
So Paulo: Conselho Regional de Medicina do Estado de So Paulo, 2008. 689 p.
Cruz FJSM, Del Giglio A. Preveno de nusea e vmitos induzidos por quimioterapia. Revista Brasileira de Medicina, 67(Especial Oncologia):14-8, 2010.
CTCAE - Cancer Therapy Evaluation Program: Common Terminology Criteria for Adverse Events, Version 3.0. Bethesda, Md: National Cancer Institute, Division of Cancer
Treatment and Diagnosis, 2006. Disponvel em <http://ctep.cancer.gov/protocolDevelopment/electronic_applications/docs/ctcaev3.pdf> Acesso em 15/03/2011.
Daub EA, Gerhard I, Bastert G. Homeopathic antiemesis for chemotherapy, a prospective randomised trial. Geburtshilfe und Frauenheilkunde, 60:S157, 2005.
De Mulder PH, Seynaeve C, Vermonrken JB, Van Liessum PA, Mols-Jedevic S, Allman EL, BeraneK P Verweij J. Ondasetron compared with high dose
metoclopramide in prophylaxis of acute and delayed cisplatin-induced nausea and vomiting. A multicenter, randomized, double-blind, cross-over study.
Ann Intern Med, 113(11):834-40, 1990.
Dibble S, Chapman J, Mack K, Shih A. Acupressure for nausea: results of a pilot study. Oncology Nursing Forum, 27(1):41-7, 2000.
Doan, BD. Alternative and complementary therapies. In: Holland JC. Psycho-oncology. New York: Oxford. 1998. p. 817-827.
Dundee J, Ghaly R, Fitzpatrick K, Lynch G, Abram W. Acupuncture to prevent cisplatin-associated vomiting. Lancet, 1(8541):1083, 1987.
Dundee J, Ghaly R, Fitzpatrick K, Lynch G, Abram W. Randomized comparison of the antiemetic effecs of metoclopramide and electroacupuncture in
cancer chemotherapy. British Journal of Clinical Pharmacology, 25(6):678-9, 1988.
Einhorn LH, Grunberg SM, Rapoport B, Rittenberg C, Feyer P. Antiemetic therapy for multiple-day chemotherapy and additional topics consisting of rescue antiemetics and high-risk chemotherapy with stem cell transplantation: review and consensus statement. Supportive Care Cancer, 19(Suppl 1):S1-4, 2011.
Elias ACA. Relaxamento mental, imagens mentais e espiritualidade na re-significao da dor simblica da morte de pacientes terminais. In: Pimenta CAM,
Mattos-Pimenta CA, Mota DDCF, Cruz, DALM. Dor e cuidados paliativos: enfermagem, medicina e psicologia. Barueri: Manole, 2006. v.1, p.338.
Elsayem A., Driver L, Bruera E. Principles. In Elsayem A, Driver L, Bruera E. The M.D Anderson Symptom Control and Palliative care Handbook. 2nd
ed, Houston, The University of Texas MD Anderson Cancer Center, 2002, p. 3-8.
Epelman S et al. Manual de Cuidados Paliativos INCTR Brasil. So Paulo: Masterede Marketing e Editora, 2010.
Ezzo J, Richardson MA, Vickers A, Allen C, Dibble S, Issell BF, Lao L, Pearl M, Ramirez G, Roscoe JA, Shen J, Shivnan JC, Streitberger K, Treish I, Zhang
G. Acupuncture-point stimulation for chemotherapy-induced nausea or vomiting (Review). The Cochrane Library, Issue 1, 2010, Issue 1. Disponvel em
<www.thecochranelibrary.com/userfiles/ccoch/file/Acupuncture_ancient_traditions/CD002285.pdf> Acesso em 05/06/2011.
Fellowes D, Barnes K, Wilkinson S. Aromatherapy and massage for symptom relief in patients with cancer. Cochrane Database of Systematic Reviews, Issue 12, 2010.
Figueroa-Moseley C, Jean-Pierre P, Roscoe JA, Ryan JL, Kohli S, Palesh OG, Ryan EP, Carroll J, Morrow GR. Behavioral interventions in treating anticipatory nausea and vomiting. J Natl Compr Canc Netw, 5(1):44-50, 2007.
Filshie J. Safety aspects of acupuncture in palliative care. Acupuncture in Medicine, 19(2):117-22, 2001.
Friedel WE, Matthes H, Bock PR, Znker KS. Systematic evaluation of the clinical effects of supportive mistletoe treatment within chemo- and/or radiotherapy protocols and long-term mistletoe application in nonmetastatic colorectal carcinoma: multicenter, controlled, observational cohort study. J Soc
Integr Oncol, 7(4):137-45, 2009.
Gharote ML, Gharote MM. Swami Kuvalayananda. Lonavla: Lonavla Yoga Institute, 1999. 168 p.
Gore L, Chawla S, Petrilli A, Hemenway M, Schissel D, Chua V, Carides AD, Taylor A, Devandry S, Valentine J, Evans JK, Oxenius B. Aprepitant in
adolescent patients for prevention of chemotherapy-induced nausea and vomiting: a randomized, double-blind, placebo-controlled study of efficacy
and tolerability. Pediatr Blood Cancer, 52(2):242-7, 2009.
Graham-Pole J, Weare J, Engel S, Gardner R, Mehta P, Gross S. Antiemetics in children receiving cancer chemotherapy: a double-blind prospective
randomized study comparing metoclopramide with chlorpromazine. J Clin Oncol, 4(7):1110-3, 1986.
Grealish L, Lomasney A, Whiteman B. Foot massage: a nursing intervention to modify the distressing symptoms of pain and nausea in patients hospitalized with cancer. Cancer Nursing, 23(3):237-43, 2000.
Groenvold M, Petersen MA, Aaronson NK et al. The development of the EORTC QLQ-C15-PAL: A shortened questionnaire for cancer patients in palliative
care. European Journal of Cancer, 42(1):55-64, 2006.
Grupo de Trabajo de la Gua de Prctica Clnica sobre Cuidados Paliativos. Gua de Prctica Clnica sobre Cuidados Paliativos. Madrid: Plan Nacional para
el SNS del MSC. Agencia de Evaluacin de Tecnologas Sanitarias del Pas Vasco; 2008. Guas de Prctica Clnica en el SNS: OSTEBA N 2006/08.
Guideline Summary NCG-6067. Nausea and Vomiting. Editorial Board Palliative Care: Practice Guidelines. Nausea and Vomiting. Utrecht: Association
of Comprehensive Cancer Centres (ACCC), 2006. 28 p.
Harris DG. Nausea and vomiting in advanced cancer. British Medical Bulletin, 96:175-85, 2010.
Hasler SB, Hirt A, Ridolf Luethy A,Leibundgut KK, Ammann RA. Safety of ondansetron loading doses in children with cancer. Support Care Cancer, 16(5):469-75, 2008.
Heiny B-M, Albrecht V, Beuth J. Lebensqualittsstabilisierung durch Mistellektin-1 normierten Extrakt beim fortgeschrittenen kolorektalen Karzinom.
Onkologe, 4(suppl 1):35-9, 1998.
Hesketh PJ. Chemotherapy-Induced Nausea and Vomiting. N Engl J Med, 358(23):2482-94, 2008.
Heusser P, Braun SB, Bertschy M, Burkhard R, Ziegler R, Helwig S, van Wegberg B, Cerny T. Palliative In-Patient Cancer Treatment in an Anthroposophic
Hospital: II. Quality of Life during and after Stationary Treatment, and Subjective Treatment Benefits. Forsch Komplementarmed, 13(3):156-66, 2006.

Levine ME, Gillis MG, Koch SY, Voss AC, Stern RM, Koch KL. Protein and Ginger for the Treatment of Chemotherapy-Induced Delayed Nausea. Journal
of Alternative and Complementary Medicine, 14(5): 545-51, 2008.
Lichter I. Results of antiemetic management in terminal illness. J Palliat Care, 9(2):19-21, 1993.
Loewe-Mesch A, Kuehn JH, Borho K et al. Adjuvante simultane Mistel-/Chemotherapie bei Mammakarzinom: Einfluss auf Immunparameter, Lebensqualitt
und Vertrglichkeit. Forsch Komplementmed, 15:22-30, 2008.
Lpez R, Nervi F, Taboada P. Manual de Medicina Paliativa. Santiago: Pontificia Universidad Catlica de Chile, 2005. p. 58-61.
Lotfi-Jam K, Carey M, Jefford M, Schofield P, Charleson C, Aranda S. Nonpharmacologic strategies for managing common chemotherapy adverse
effects: a systematic review. J Clin Oncol, 26(34):5618-29, 2008.
Luisi FA, Petrilli AS, Tanaka C, Caran EM. Contribution to the treatment of nausea and emesis induced by chemotherapy in children and adolescents
with osteosarcoma. Sao Paulo Med J, 124(2):61-5, 2006.
Luisi FAV. Contribuio para o tratamento da nusea e do vmito induzidos pela quimioterapia em crianas e adolescentes com osteossarcoma. 1995.
Dissertao (Mestrado Pediatria). Universidade Federal de So Paulo.
Lyles JN, Burish TG, Krozely MG, et al. Efficacy of relaxation training and guided imagery in reducing the adversiveness of cancer chemotherapy. J
Consult Clin Psychol, 50(4):509-24, 1982.
Macieira RC, Barbosa ERC. Olhar paciente-famlia: incluindo a unidade de cuidados no atendimento integral. In: Veit MT. Org. Transdisciplinaridade
em oncologia. So Paulo: HR Grfica e Editora, 2009.
Macmillan K et al. A Caregivers Guide: A handbook about end-of-life care. Ottawa: The Military and Hospitaller Order of St. Lazarus of Jerusalem
& The Canadian Hospice Palliative Care Association 2004. 174 p. Disponvel em < http://www.pallium.ca/infoware/ACaregiversGuide_English.
pdf> Acesso em 14/04/2011.
Mannix K. Palliation of nausea and vomiting. In Doyle D et al. Oxford Textbook of Palliative Medicine. 2 ed. Oxford: Oxford University Press,1998. p. 489-98.
Marchioro G, Azzarello G, Viviani F, Barbato F, Pavanetto M, Rosetti F, Pappagallo GL, Vinante O. Hypnosis in the treatment of anticipatory nausea
and vomiting in patients receiving cancer chemotherapy. Oncology, 59(2):100-4, 2000.
Marshall G, Kerr S, Vowels M, O`Gorman-Hughes D, White L. Antiemetic therapy for chemotherapy-induced vomiting: metoclopramide, benztropine,
dexamethasone, and lorazepam regimen compared with chlorpromazine alone. J Pediatr, 115(1):156-60, 1989.
Martin AR, Carides AD, Pearson JD, Horgan K, Elmer M, Schmidt C, Cai B, Chawla SP, Grunberg SM. Functional relevance of antiemetic control:
experience using the FLIE questionnaire in a randomized study of the NK-1 antagonist aprepitant. Eur J Cancer, 39(10):1395-401, 2003.
Martin AR, Pearson JD, Cai B, Elmer M, Horgan K, Lindley C. Assessing the impact of chemotherapy induced nausea and vomiting on patients daily
lives: a modified version of the Functional Living Index-Emesis (FLIE) with 5-day recall. Support Care Cancer, 11(8):5227, 2003.
Matthes H, Friedel WE, Bock PR. Supportive care in pancreatic carcinoma patients treated with a fermented mistletoe (Viscum album L.) extract. Paper
presented at the ASMO Conference Lugano; 5-8 July, 2007; Lugano, Switzerland.
McDonald A, Burjan E, Martin S. Yoga for patients and carers in a palliative day care setting. International Journal of Palliative Nursing, 12(11):519-23, 2006.
McMillan C, Dundee JW, Yang J. Non-invasive stimulation of the P6 (Neiguan) antiemetic acupuncture point in cancer chemotherapy. Journal of the
Royal Society of Medicine, 84(4):210-2, 1991.
Mehta P, Gross S, Graham-Pole J, Gardner R. Methylprednisolone for chemotherapy-induced emesis: double-blind randomized trial in children. J Pediatr,
108(5 Pt 1):774-6, 1986.
Mercadante S, Fulfaro F, Casuccio A. The impact of home palliative care on symptoms in advanced cancer patients. CA Cancer J Clin, 8(4):307-10, 2000.
Molassiotis A et al.Validation and Psychometric Assessment of a Short Clinical Scale to Measure Chemotherapy-Induced Nausea and Vomiting: The
MASCC Antiemesis Tool. Journal of Pain and Symptom Management, 34(2):148-59, 2007.
Molassiotis A, Yung Hilary P, Yam Bernard MC, et al. The effectiveness of progressive muscle relaxation training in managing chemotherapy-induced
nausea and vomiting in Chinese breast cancer patients: A randomised control trial. Support Care Cancer, 10(3):237-46, 2002.
Molassiotis A. A pilot study of the use of progressive muscle relaxation training in the management of post-chemotherapy nausea and vomiting. Eur J
Cancer Care, 9(4):230-4, 2000.
Monteiro DR. Escala de Avaliao de Sintomas de Edmonton: Reviso Integrativa. Trabalho de Concluso de Curso. EEUFRGS. 2009. Disponvel em:
<http://www.lume.ufrgs.br/bitstream/handle/10183/24699/000748477.pdf?sequence=1> Acesso em 03/03/2011.
Montgomery GH, Hallquist MN, Schnur JB, David D, Silverstein JH, Dana H. Bovbjerg DH. Mediators of a Brief Hypnosis Intervention to Control Side
Effects in Breast Surgery Patients: Response Expectancies and Emotional Distress. Journal of Consulting and Clinical Psychology, 78(1):808, 2010.
Morrow G, Rosenthal S. Models, mechanism and management of anticipatory nausea and vomiting. Oncology, 53(Suppl.1):4-7, 1996.
Morrow GR, Asbury R, Hammon S, et al. Comparing the effectiveness of behavioral treatment for chemotherapy-induced nausea and vomiting when
administered by oncologists, oncology nurses, and clinical psychologists. Health Psychol, 11(4):250-6, 1992.
Morrow GR, Roscoe JA, Hickok JT. Nausea and Vomiting. In: Holland JC. Psycho-oncology. New York: Oxford. 1998. p. 473-84.
Morrow GR. Effect of the cognitive hierarchy in the systematic desensitization treatment of anticipatory nausea in cancer patients: A component comparison with relaxation only, counseling, and no treatment. Cognit Ther Res, 10(4):421-46, 1986.
Murray K. Essentials in Hospice Palliative Care. 2nd ed. Saanichton: Life and Death Matters. 2009. 172 p.
Myers CD, Walton T, Brastman L, Wilson J, Small B. Massage modalities and symptoms reported by cancer patients: narrative review. Journal of the
Society for Integrative Oncology, 6(1):19-28, 2008.
Navari RM. Pharmacological management of chemotherapy-induced nausea and vomiting, focus on recent developments. Drugs, 69(5):515-33, 2009.
Noga S, Tolman A, Roman J. Acupressure as an adjunct to pharmacologic control of nausea, vomiting and retching during blood and marrow transplan-

Holdsworth MT, Raich DW, Frost J. Acute and delayed nausea and emesis control in pediatric oncology patients. Cancer, 106(4):931-40, 2006.
Holland JC. Societal Views of Cancer and the emergence of Psycho-oncology. In: Holland JC. Psycho-oncology. New York: Oxford. 1998. p. 3-15.
INCA Instituto Nacional de Cncer. Cuidados paliativos oncolgicos: controle de sintomas. Rio de Janeiro: INCA, 2001.
INCA Instituto Nacional de Cncer. Normas e Recomendaes. Revista Brasileira de Cancerologia, 46(3): 243-56, 2000.
Jahn P, Renz P, Stukenkemper J, Book K, Kuss O, Jordan K, Horn I, Thoke-Colberg A, Schmoll HJ, Landenberger M. Reduction of chemotherapy-induced anorexia, nausea, and emesis through a structured nursing intervention: a cluster-randomized multicenter trial. Support Care Cancer, 17(12):154352, 2009.
Jocham HR, Dassen T, Widdershoven G, Halfens R. Quality of life in palliative care cancer patients: a literature review. J Clin Nurs, 15(9):1188-95, 2006.
Jordan K, Roila F, Molassiotis A, Maranzano E, Clark-Snow RA, Feyer P. Antiemetics in children receiving chemotherapy. MASCC/ESMO guideline
update 2009. Support Care cancer, 19(Suppl 1):S37-42, 2011.
Jrgens H, McQuade B. Ondasetron as profylaxis for chemotherapy and radiotherapy induced emesis in children. Oncology, 49(4):279-85, 1992.
Karwacki MW. Gastrointestinal symptoms. In: Oxford Textbook of Palliative Care for Children. New York: Oxford University Press, 2007. p. 342-73.
Kassab S, Cummings M, Berkovitz S, van Haselen R, Fisher P. Homeopathic medicines for adverse effects of cancer treatments. Cochrane Database
Sust Rev, (2):CD004845, 2009.
Kienle GS, Kiene H. Influence of Viscum album L (European Mistletoe) Extracts on Quality of Life in Cancer Patients: A Systematic Review of Controlled
Clinical Studies. Integrative Cancer Therapies, 9(2) 142-157, 2010.
Kris MG et al. American Society of Clinical Oncology - Guidelines for Antiemetics in Oncology: Update 2006. Journal of Clinical Oncology, 24(18):2932-47, 2006.
Lee A, Done ML. The use of nonpharmacologic techniques to prevent postoperative nausea and vomiting: a meta-analysis. Anesth Analg, 88(6):1362-9, 1999.

tation: a randomized, placebo-controld, algorithm based study. Proceedings of the American Society of Clinical Oncology, 21:361a, 2002.
Northouse, LL. Katapodi,MC, Song,L. Zang L, Mood, D.W. Interventions with Family Caregivers of Cancer Patients: Meta-Analysis of Randomized Trials.
CA Cancer J Clin, 60(5):317-39, 2010.
OBrien C. Nausea and vomiting. Can Fam Physician, 54(6):861-3, 2008.
OMS Organizao Mundial de Sade. Definition of Palliative Care. Disponvel em <www.who.int/cancer/palliative/definition/en/> Acesso em 01/05/2011.
OPS - Organizao Panamericana de Sade e IAHPC - International Association for Hospice and Palliative Care. Cuidados Paliativos - Guas para el
manejo clnico, 2004. Disponvel em <http://cuidadospaliativos.org/recursos/manuales-y-guias> Acesso em 01/04/2011.
Pan CX, Morrison RS, Ness J, Fugh-Berman A, Leipzig RM. Complementary and Alternative Medicine in the Management of Pain, Dyspnea, and Nausea
and Vomiting Near the End of Life: A Systematic Review. Journal of Pain and Symptom Management, 20(5):374-87, 2000.
Perkins P, Vowler SL. Does acupressure help reduce nausea and vomiting in palliative care patients? Pilot study. Palliative Medicine, 22(2):193-4, 2008.
Piao BK, Wang YX, Xie GR et al. Impact of complementary mistletoe extract treatment on quality of life in breast, ovarian and non-small cell lung cancer
patients. A prospective randomized controlled clinical trial. Anticancer Res, 24(1):303-9. 2004.
Pillai AK, Sharma KK, Gupta YK, Bakhshi S. Anti-Emetic Effect of Ginger Powder Versus Placebo as an Add-On Therapy in Children and Young Adults
Receiving High Emetogenic Chemotherapy. Pediatr Blood Cancer, 56(2):234-8, 2011.
Pusch F, Freitag H, Goll V et al. Electrical stimulation of the vestibular system prevents postoperative nausea and vomiting. Acta Anaesthesiol Scand, 44(9):1145-48, 2000.
Raghavendra RM, Nagarathna R, Nagendra HR, Gopinath KS, Srinath BS, Ravi BD ET AL. Effects of an integrated yoga programme on chemotherapy
induced nausea and emesis in breast cancer patients. Eur J Cancer Care, 16(6):462-74, 2007.

B r a s i l e i r a

)'((

d e

C u i d a d o s

Pa l i a t i v o s

2 011;

(3)

S u p l e m e n t o

Re v i s t a

B r a s i l e i r a

d e

C u i d a d o s

Pa l i a t i v o s

2 011;

(3)

S u p l e m e n t o

)-

)'((

:fej\ejf9iXj`c\`if[\E}lj\Xj\Md`kfj

SUPLEMENTO2
Rhodes VA, McDaniel RW. Nausea, Vomiting, and Retching: Complex Problems in Palliative Care. CA Cancer J Clin, 51(4):232-48, 2001.
Richardson MA, Sanders T, Palmer JL, Greisinger A, Singletary SE. Complementary/Alternative Medicine Use in a Comprehensive Cancer Center and
the Implications for Oncology. Journal of Clinical Oncology, 18(13):2505-14, 2000.
Roila F et al. Guideline update for MASCC and ESMO in the prevention of chemotherapy- and radiotherapy-induced nausea and vomiting: results of
the Perugia consensus conference. Annals of Oncology, 21(Suppl 5):232-43, 2010.
Roila F, Feyer P, Maranzano E, Olvre I, Clarck-Snow R, War D, Molassiotos A. Antiemetics in children receiving chemotherapy. Support Care Cancer, 13(2):129-31, 2005.
Roscoe JA, Morrow GR, Bushunow P, Tian L, Matteson S. Acustimulation wristbands for the relief of chemotherapy-induced nausea. Alternative Therapies
in Health and Medicine, 8(4):56, 2002.
Roscoe JA, Morrow GR, Hickok JT et al. The Efficacy of Acupressure and Acustimulation Wrist Bands for the Relief of Chemotherapy-Induced Nausea
and Vomiting. Journal of Pain and Symptom Management, 26(2):731-42, 2003.
Ryan JL, Heckler C, Dakhil SR, Kirshner J, Flynn PJ, Hickok JT, Morrow GR. Ginger for chemotherapy-related nausea in cancer patients: A URCC CCOP
randomized, double-blind, placebo-controlled clinical trial of 644 cancer patients. J Clin Oncol, 27(15s): abstract 9511, 2009.
Saito M et al. Palonosetron plus dexamethasone versus granisetron plus dexamethasone for prevention of nausea and vomiting during chemotherapy:
a double-blind, double-dummy, randomized, comparative phase III trial. Lancet Oncology, 10(2):15-24, 2009.
Saller R, Hellenbrecht D, Bhring M, Hess H. Enhancement of the antiemetic action of metoclopropamide against cisplatin induced emesis by transdermal
electrical nerve stimulation. J Clin Pharmacol, 26(2):115-9, 1986.
Santucci G, Mack JW. Common Gastrointestinal Symptoms in Pediatric Palliative Care: Nausea, Vomiting, Constipation, Anorexia, Cachexia. Pediatr
Clin N Am, 54(5):673-89, 2007.
Saxby C et al. How should we measure emesis in palliative care? Palliative Medicine, 21(5):369-83, 2007.
Schumacher K, Schneider B, Reich G, et al. Influence of postoperative complementary treatment with lectin-standardized mistletoe extract on breast
cancer patients: a controlled epidemiological multicentric retrolective cohort study. Anticancer Res, 23(6D):5081-8, 2003.
Semiglasov VF, Stepula VV, Dudov A, Lehmacher W, Mengs U. The standardised mistletoe extract PS76A2improves QoL in patients with breast cancer receiving
adjuvant CMF chemotherapy: a randomised, placebo-controlled, double-blind, multicentre clinical trial. Anticancer Res, 24(2C):1293-302, 2004.
Semiglasov VF, Stepula VV, Dudov A, Schnitker J, Mengs U. Quality of life is improved in breast cancer patients by standardized mistletoe extract PS76A2
during chemotherapy and follow-up: a randomised, placebo-controlled, double-blind, multicentre clinical trial. Anticancer Res, 26(2B):1519-30, 2006.
Shen J. Electroacupuncture for Control of Myeloablative Chemotherapy-Induced Emesis: A Randomized Controlled Trial. The Journal of the American
Medical Association, 284(21):2755-61, 2000.
Shin YH, Kim TI, Shin MS, et al. Effect of acupressure on nausea and vomiting during chemotherapy cycle for Korean postoperative stomach cancer
patients. Cancer Nurs, 27(4):26774, 2004.
Silva YB, Silva J. Controle de Nuseas e Vmitos. In: Pimenta CAM et al. Dor e cuidados paliativos: enfermagem, medicina e psicologia. Barueri: Manole, 2006. p. 253-61.
Souto A. Una Luz para El Hatha Yoga - traduccin y comentario sobre El Hatha Pradipika. Buenos Aires: Lonavla Yoga Institute; 1998. 281 p.
Srivastava, M, N Brito-Dellan, M P Davis, et al. Olanzapine as an antiemetic in refractory nausea and vomiting in advanced cancer. Journal of Pain
and Symptom Management, 25(6):578-82, 2003.
Stephenson J, Davies A. An assessment of etiology-based guidelines for the management of nausea and vomiting in patients with advanced cancer.
Support Care Cancer, 14(4):348-53, 2006.
Streitberger K, Friedrich-Rust M, Bardenheuer H, Unnebrink K, Windeler J, Goldschmidt H, et al. Effect of acupuncture compared with placebo-acupuncture at P6 as additional antiemetic prophylaxis in high-dose chemotherapy and autologous peripheral blood stem cell transplantation: a randomized
controlled single-blind trial. Clinical Cancer Research, 9(7):2538-44, 2003.
Syrjala KL, Cummings C, Donaldson GW. Hypnosis or cognitive behavioral training for the reduction of pain and nausea during cancer treatment: a
controlled clinical trial. Pain, 48(2):137-46, 1992.
Syrjala KL, Donaldson GW, Davis MW, Kippes ME, Carr JE. Relaxation and imagery and cognitive-behavioral training reduce pain during cancer
treatment: a controlled clinical trial. Pain, 63(2):189-98, 1995.
Taimni IK. A Cincia do Yoga. Braslia: Teosfica, 1996. 344 p.
Tan L, J Liu, X Liu et al. Clinical research of olanzapine for prevention of chemotherapy-induced nausea and vomiting. Journal of Experimental & Clinical
Cancer Research, 28:131, 2009.
Teunissen SC, Wesker W, Kruitwagen C et al. Symptom prevalence in patients with incurable cancer: A systematic review. Journal of Pain and Symptom
Management, 34(1):94-104, 2007.
Treish I, Shord S, Valgus J et al. Randomized double-blind study of the Reliefband as an adjunct to standard antiemetics in patients receiving moderatelyhigh to highly emetogenic chemotherapy. Supportive Care in Cancer, 11(8):516-21, 2003.
Trger W, Matijasevic M, Zdrale Z, Tisma N, Jezdic S. Additional therapy with mistletoe extracts in breast cancer patients receiving chemotherapy:
a prospective randomized open label pilot study. In: Scheer R, Alban S, Becker H, et al, eds. Die Mistel in der Tumortherapie 2. Aktueller Stand der
Forschung und klinische Anwendung. Essen, Germany: KVC-Verlag, 2009. p. 509-21.
Turk DC, Feldman CS. Cognitive-behavioral approaches to symptom management in palliative care: aumenting somatic interventions. In: Chochinov
HM, Breitbart W. Handbook of psychiatry in palliative medicine. 2nd ed. New York: Oxford. 2009. p. 470-89.
UnATI - Universidade Aberta da Terceira Idade. Universidade Estadual de Maring. Unidade de Cuidados/UNIC. Manual de cuidados paliativos em
pacientes com cncer. Rio de Janeiro: UNATI/UERJ-Universidade Aberta da Terceira idade, 2009. 85 p.
Vadiraja SH, Rao MR, Nagendra R, Rekha M, Vanitha N, Gopinath SK ET AL. Effects of yoga on symptom management in breast cancer patients: A
randomized controlled Trial. Int J Yoga, 2(2):73-9, 2009.
Vainio A, Auvinen A. Prevalence of symptoms among patients with advanced cancer: An international collaborative study - Symptom Prevalence Group.
Journal of Pain and Symptom Management, 12(1):3-10, 1996.
Vasterling J, Jenkins RA, Tope DM et al. Cognitive distraction and relaxation training for the control of side effects due to cancer chemotherapy. J Behav
Med, 16(1):65-80, 1993.
Watson MS. Oxford Handbook of Palliative Care. New York: Oxford University Press, 2005.
Watts A, Guarino J. Management of Physical Symptoms. In: Cure Search Childrens Oncology Group and Association of Pediatric Hematology/Oncology
Nurses. Pediatric Oncology Palliative and End-of-Life Care Resource, 2010. p.13-70.
Williams SA, Schreier AM. The effect in managing effects in women receiving chemotherapy for treatment of breast cancer. Oncology Nursing Forum, 31(1):E16-23, 2004.
Yamada K; Yagi G; Kanba S. Effectiveness of Gorei-san (TJ-17) for treatment of SSRI-induced nausea and dyspepsia: preliminary observations. Clin
Neuropharmacol, 26(3):112-4, 2003.
Zrate E, Mingus E, White PF et al. The use of transcutaneous acupoint electrical stimulation for preventing nausea and vomiting after laparoscopic
surgery. Anesth Analg, 92(3):629-35, 2001.
Zeltzer LK, Dolgin MJ, LeBaron S, et al. A randomized, controlled study of behavioral intervention for chemotherapy distress in children with cancer.
Pediatrics, 88(1):34-42, 1991.
Zick SM, Ruffin MT, Lee J, Normolle DP, Siden R, Alrawi S, Brenner DE. Phase II trial of encapsulated ginger as a treatment for chemotherapy-induced
nausea and vomiting. Support Care Cancer, 17(5):563-72, 2009.

Re v i s t a

B r a s i l e i r a

d e

C u i d a d o s

Pa l i a t i v o s

2 011;

(3)

S u p l e m e n t o

)/

)'((

:fej\ejf9iXj`c\`if[\E}lj\Xj\Md`kfj

SUPLEMENTO2

ABCP
Associao
Brasileira
de Cuidados
Paliativos

Re v i s t a

B r a s i l e i r a

d e

C u i d a d o s

Pa l i a t i v o s

2 011;

(3)

S u p l e m e n t o

Você também pode gostar