Prescribing in palliative care

Question 1

Which drugs are compatible with diamorphine in continuous SC infusions?

Answer 1

• cyclizine
• haloperidol
• dexamethasone
• hyoscine
• levomepromazine
• metoclopramide
• midazolam

Question 2

Regarding cyclizine, does it precipitate when mixed with diamorphine?

Answer 2

• It precipitates at concentration > 10mg/mL or in presence of saline or as concentration of diamorphine to cyclizine increases. Mixtures likely to precipitate after 24h.

Question 3

Regarding haloperidol, does it precipitate when mixed with diamorphine?

Answer 3

Haloperidol mixtures of diamorphine likely to precipitate after 24h if concentrations > 2mg/mL

Question 4

Symptom Control - RESTLESSNESS and CONFUSION

Answer 4

• haloperidol

- levomepromazine

Question 5

Symptom Control - RAISED INTRACRANIAL PRESSURE

Answer 5

• dexamethasone

Question 6

Symptom Control - N/V

Answer 6

• cyclizine
• metoclopramide
• haloperidol

Question 7

Symptom Control - INTRACTABLE COUGH

Answer 7

• morphine

Question 8

Symptom Control - MUSCLE SPASM

Answer 8

• diazepam

- baclofen

Question 9

Symptom Control - INSOMNIA

Answer 9

• benzodiazepines: temazepam

Question 10

Symptom Control - EXCESSIVE RESPIRATORY SYMPTOMS

Answer 10

• hyoscine butylbromide
• hyoscine hydrobromide
• glycopyrronium bromide

Question 11

Symptom Control - CONSTIPATION

Answer 11

• lactulose + senna

- co-danthramer

Question 12

Symptom Control - CONVULSIONS

Answer 12

• midazolam

- diazepam

Question 13

Symptom Control - DRY MOUTH

Answer 13

• suck ice

- artificial saliva

Question 14

Symptom Control - PAIN

Answer 14

• diamorphine

Question 15

Symptom Control - DIFFICULTY BREATHING

Answer 15

• morphine
• dexamethasone
• diazepam

Question 16

Symptom Control - GI PAIN

Answer 16

• loperamide
• hyoscine butylbromide
• hyoscine hydrobromide
• glycopyrronium bromide
• domperidone