The use of alfentanil in a syringe driver in palliative. Pdf the benefits and drawbacks of syringe drivers in. Cyclizine lactate 50 mgml injection summary of product. Indications, dose, contraindications, sideeffects, interactions, cautions, warnings and. Symptom drug subcutaneous prn dosedoses for anticipatory symptoms subcutaneous starting dose range over 24 hours in syringe driver subcutaneous maximum dose over 24 hours.
Cyclizine is licensed in new zealand to a maximum dose of 150mg daily1 although doses up to 200mg daily can be used in palliative care. Dose conversion alfentanil is approximately 15 times as potent as subcutaneous sc morphine. Diamorphine pain total daily dose of oral 5,10,30,100,500 mg cyclizine. Syringe driver drug compatibilities guide to palliative care practice 2016 sodium chloride 0. Cyclizine given intravenously, in half the recommended dose, increases the lower. Cyclizine with diamorphine, once diamorphine dose exceeds 200 mg24 hours. Syringe drivers continuous subcutaneous infusion marie curie. A compatibility chart based on studies performed at specified drug concentrations is shown below. Cyclizine syringe driver download it allows the continuous delivery of a range of therapies to aid patient comfort. Cyclizine is licensed in new zealand to a maximum dose of 150mg daily1 although. Diamorphine alternatives morphine 10mgml and 30mgml ampoules or oxycodone 10mg1ml, 20mg2ml or 50mg1ml are used as alternatives to diamorphine in some circumstances, and will mix with other drugs in a syringe driver similar to diamorphine.
For information on the usual doses of drugs used in a syringe driver see inside. Cyclizine does not mix with oxycodone at therapeutic doses. Dexamethasone compatibility is unpredictable and is best given in a separate syringe driver pump if possible or as a bolus subcutaneous dose once daily. A syringe driver takes 34 hours to establish a steady state drug level in plasma. This guideline refers to the use of drugs in syringe drivers for palliative care only. By rectum for child 25 years valoid may mask the warning signs of.
When added to a syringe driver the diluent must be water for injection. It causes precipitation with saline and with diamorphine doses. When changing the syringe driver using new medication 15. Use either water for injection or sodium chloride 0. If the patient is in pain, vomiting or very agitated, give a stat sc injection of appropriate medication while setting up the syringe driver. Drugs for subcutaneous administration in syringe drivers. You might have been given a syringe driver, to help control pain, sickness, agitation or fits. T34 adult syringe driver guidelines nhs harrogate and rural. Give 115 of the 24 hour dose po morphine to sc alfentanil. The dose of opioid in a csci by syringe driver should be determined by the. Refer to relevant guidelines to obtain usual dose range for each medication. When and how to use a syringe driver in palliative. The benefits and drawbacks of syringe drivers in palliative car e. Local palliative care guidelines should always be followed when mixing drugs in a syringe driver.