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Any unused product or waste material should be disposed of in accordance with local requirements. State the dose and diluents, and remember a triplicate controlled drug prescription for any opioids. For example, a patient with severe nausea and vomiting that temporarily prevents the use of oral medicines may need a syringe driver to gain control of symptoms.
DIAMORPHINE HYDROCHLORIDE | Drug | BNF content published by NICE
Precipitation may occur as a diamorphhine of a reaction between medicines in a syringe. CNS depression ; severe cor pulmonale ; severe diarrhoea ; toxic psychosis. With guidance and support from the local hospice or district nursing services, General Practitioners can arrange a syringe driver infusion for a patient in their home or in a residential care facility, prescribe and monitor the appropriate mix of medicines and manage breakthrough symptoms. For further information see: Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme at: By subcutaneous injection, or by intramuscular injection.
Reporting of suspected adverse reactions Reporting suspected adverse reactions after authorisation of viluting medicinal product is important.
Other drugs classified as opioids. Controlled drugs that are no longer required for a patient can be returned to the pharmacy or general dluting for safe disposal.
When and how to use a syringe driver in palliative care
Delayed gastric emptying ; phaeochromocytoma. In general, avoid combining more than three medicines in one syringe occasionally more than one syringe driver is required. Normal saline is also compatible with most medicines with some exceptions, e. If treatment continues for more than 24 hours it may be appropriate to use a syringe driver Burne R, Hunt A, Palliative Medicine1, Children and Elderly: In a palliative care setting, subcutaneous administration of medicines given via a syringe driver is useful for managing symptoms such as pain, nausea, anxiety and restlessness.
Continuous subcutaneous infusion should be monitored regularly both to check for precipitation and discoloration and to ensure that the diluitng is running at the correct rate.
Usual starting doses for subcutaneous infusion for commonly used medicines are: Less diamorphine will therefore be needed. Selection of the infusion site Plastic cannulae are recommended, syriinge metal butterfly needles can be used. Comments There are currently no comments for this article.
If breakthrough pain occurs give a subcutaneous preferable or intramuscular injection of diamorphine equivalent to one-sixth of the total hour subcutaneous infusion dose. The analgesic effect lasts approximately three to four hours. When more than one medicine is used in an infusion solution there is a risk that they may not be compatible, either chemically or physically.
Diamorphine Hydrochloride BP 100 mg Lyophilisate for Solution for Injection
The usual initial dosage for children is 10 micrograms per kg body weight. For storage conditions of the reconstituted medicinal product, see section 6. Monoacetylmorphine is metabolised to morphine. Name of the medicinal product 2.
Compatibility of medicines for syringe driver infusions commonly prescribed in general practice Adapted from Palliative Care Handbook Guidelines for the use of subcutaneous medications in palliative care for adults - primary care and hospices. Related Treatment Summaries Acute coronary syndromes Analgesics Aromatic inhalations, cough preparations and systemic nasal dilutting Medical emergencies in the community Other drugs classified as opioids.
If problems arise with an infusion site the patient may have localised discomfort, or there may be reduced absorption of the medicine duluting a loss of symptom control.
By slow intravenous injection For Adult 1. By slow intravenous injection, one quarter to one half the corresponding intramuscular dose. Prescribe the doses of the subcutaneous medicines to cover a hour period.
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