Syringe Drivers

Question 1

What is a syringe driver? What route ate the used in the palliative care setting?

Answer 1

• A portable, battery driven device which delivers continuous infusion of drugs over a predetermined time
• Usually given via subcutaneous route
  
  • as drugs well absorbed and sites can easily be changed by nursing staff

Question 2

What are the indications for a syringe driver?

Answer 2

• Inability to swallow drugs due to reduced conscious level, often in the last few days of life
• Persistent nausea and vomiting
• Intestinal obstruction
• Malabsorption of drugs
• Dysphagia

Question 3

What drugs are commonly used in a syringe driver?

Answer 3

• Diamorphine or morphine sulphate
  
  • analgesic
• Cyclizine
  
  • antiemetic
• Haloperidol
  
  • antiemetic, antipsychotic
• Metoclopramide
  
  • antiemetic
• levomepromazine
  
  • antiemetic, antipsychotic and sedative
• Hyoscine butylbromide
  
  • antisecretory, antispasmodic
• Hyoscine hydrobromide
  
  • antisecretory, antispasmodic
• Midazolam
  
  • sedative, anxiolytic, anticonvulsant

Question 4

What drugs are unsuitable for the subcutaneous administration route? Why?

Answer 4

Unsuitable drugs:

• diazepam
• chlorpromazine
• prochlorperazine

Why?

• Irritant via SC route