Anticipatory medicines in palliative care pro-forma V1, review date ...
Anticipatory medicines in palliative care pro-forma V1, review date ...
Anticipatory medicines in palliative care pro-forma V1, review date ...
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ANTICIPATORY MEDICATION IN PALLIATIVE CARE<br />
Usually 4 key drugs are prescribed: opioid, antiemetic, anti-agitation, anti-secretory.<br />
Prescrib<strong>in</strong>g will depend on which drugs the patient is already tak<strong>in</strong>g. Use common sense.<br />
Midazolam and Hyosc<strong>in</strong>e Butylbromide will always need prescrib<strong>in</strong>g.<br />
Anti-emetics – if patient is well controlled prescribe current antiemetic medication. See algorithm for LCP for further <strong>in</strong><strong>forma</strong>tion<br />
Inform GP that patient is be<strong>in</strong>g sent home on anticipatory medications so they know to write up medications on a community chart<br />
DRUG<br />
MORPHINE SULPHATE<br />
INJECTION<br />
OXYNORM INJECTION<br />
(OXYCODONE)<br />
ALFENTANIL<br />
INJECTION<br />
DIAMORPHINE<br />
INJECTION<br />
METHADONE<br />
INJECTION<br />
MIDAZOLAM<br />
INJECTION<br />
HYOSCINE<br />
BUTYLBROMIDE<br />
INJECTION<br />
AVAILABLE<br />
INJECTIONS<br />
10mg <strong>in</strong> 1mL<br />
30mg <strong>in</strong> 1mL<br />
10mg <strong>in</strong> 1mL<br />
20mg <strong>in</strong> 2mL<br />
50mg <strong>in</strong> 5 mL<br />
1mg <strong>in</strong> 2mL<br />
5mg <strong>in</strong> 1mL<br />
5mg <strong>in</strong> 10mL<br />
5mg, 10mg,<br />
30mg, 100mg,<br />
500mg<br />
10mg <strong>in</strong> 1mL<br />
50mg <strong>in</strong> 5mL<br />
10mg <strong>in</strong> 2mL<br />
DOSE SUPPLY COMMENTS<br />
OPIATE dose prescribed on an <strong>in</strong>dividual<br />
patient basis depend<strong>in</strong>g on opiate<br />
requirements and currently prescribed drug.<br />
Unless otherwise specified, prescribe<br />
ap<strong>pro</strong>priate dose every 3 to 4 hours PRN<br />
2.5mg to 5mg SC 4 hourly PRN (max 60mg <strong>in</strong> 24<br />
hours)<br />
Request<br />
ap<strong>pro</strong>priate supply<br />
as per patients’<br />
requirements<br />
10 (TEN) AMPOULES<br />
20mg/mL 20mg SC 4 hourly PRN (max 240mg <strong>in</strong> 24 hours) 15 AMPOULES Prescribe on eDN<br />
CYCLIZINE INJECTION 50mg/mL 25 to 50mg SC TDS PRN (max 150mg <strong>in</strong> 24 hours) 20 AMPOULES Prescribe on eDN<br />
HALOPERIDOL<br />
INJECTION<br />
LEVOMEPROMAZINE<br />
INJECTION<br />
WATER FOR<br />
INJECTIONS<br />
5mg/mL 0.5mg to 1.5mg 8 hourly PRN (max 5mg <strong>in</strong> 24 hours) 10 AMPOULES Prescribe on eDN<br />
25mg <strong>in</strong> 1mL 5mg to 6.25mg PRN (max 50mg <strong>in</strong> 24 hours) 10 AMPOULES Prescribe on eDN<br />
5mL, 10mL,<br />
20mL<br />
To be used as a diluent for syr<strong>in</strong>ge driver medication<br />
10 x 10mL<br />
AMPOULES<br />
CONTROLLED DRUG: PRESCRIBE<br />
ON HANDWRITTEN PDL. (PTO for<br />
CD prescription requirements)<br />
CONTROLLED DRUG: PRESCRIBE<br />
ON HANDWRITTEN PDL. (PTO for<br />
CD prescription requirements)<br />
Prescribe on eDN<br />
Version number: 1 Date active: 29 th March 2012 Review <strong>date</strong>: 29 th March 2014<br />
Author: Amanda Crockett Check by: Chemotherapy Development Group + Ap<strong>pro</strong>ved by: Drug and Therapeutics Committee Page 1 of 2<br />
Palliative Care Team
CONTROLLED DRUG PRESCRIPTION REQUIREMENTS<br />
The follow<strong>in</strong>g MUST be HANDWRITTEN by the prescriber on a CD prescription:<br />
Patient’s name, address and hospital number<br />
Drug name (generic and branded if ap<strong>pro</strong>priate)<br />
Strength of preparation (e.g. 10mg/5mL)<br />
Form (e.g. liquid, capsules, tablets, <strong>in</strong>jection)<br />
Quantity to supply <strong>in</strong> words and figures e.g. 56 (fifty six) tablets<br />
Dose and Dosage <strong>in</strong>terval (e.g. 20mg 4 to 6 hourly)<br />
Prescriber’s signature, bleep, pr<strong>in</strong>ted name and <strong>date</strong><br />
Version number: 1 Date active: 29 th March 2012 Review <strong>date</strong>: 29 th March 2014<br />
Author: Amanda Crockett Check by: Chemotherapy Development Group + Ap<strong>pro</strong>ved by: Drug and Therapeutics Committee Page 2 of 2<br />
Palliative Care Team
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