DIAMORPHINE THROUGH SYRINGE DRIVER

Prophylactic treatment with phenytoin or carbamazepine should be considered. Dyspnoea Breathlessness at rest may be relieved by regular oral morphine in carefully titrated doses. Acute pulmonary oedema , 2. Parenteral route The equivalent parenteral dose of morphine subcutaneous, intramuscular, or intravenous is about half of the oral dose. It is used for nausea and vomiting due to mechanical bowel obstruction, raised intracranial pressure, and motion sickness. If this fails, metoclopramide hydrochloride by mouth or by subcutaneous or intramuscular injection can be added; if this also fails, baclofen , or nifedipine , or chlorpromazine hydrochloride can be tried.

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Treatment with morphine is given by mouth as immediate-release or modified-release preparations. There may be antagonism of the gastrointestinal effects of cisapride, domperidone and metoclopramide.

For the use of midazolam by subcutaneous infusion using a continuous infusion device see below. Dexamethasone by mouth can be used as an adjunct.

Diamorphine | Cancer in general | Cancer Research UK

Formulations of fentanyl that are administered diamorphie, buccally or sublingually are also licensed for breakthrough pain. A corticosteroid such as dexamethasone may help, temporarily, if there is an obstruction due to tumour. The infusion is discontinued when the first oral dose of morphine is given. There may be increased risk of toxicity with 4-quinolone antibacterials.

An additional dose should also be given 30 minutes before an activity that causes pain, such as wound dressing. The equivalent subcutaneous dose of diamorphine diamor;hine is about one-third of the oral dose of morphine. Once their pain is controlled, patients started on 4-hourly immediate-release morphine can be transferred to the same total hour dose of morphine given as the modified-release preparation for hourly or hourly administration. Mixing and compatibility The general principle that injections should be given into separate sites and should not be mixed does not apply to the use of syringe drivers in palliative care.

Diamorphine Hydrochloride BP 100 mg Lyophilisate for Solution for Injection

Nausea and vomiting Nausea and vomiting are common diamorphien patients with advanced cancer. This has led to the use of portable continuous infusion devices, such as syringe drivers, to give a continuous subcutaneous infusionwhich can provide good control of symptoms with little discomfort or inconvenience to the patient.

These antimuscarinics are generally given every 4 hours when required, but hourly use is occasionally necessary, particularly in excessive respiratory secretions. Diamorphine has been administered in reduced doses to children with neoplastic syrijge when it becomes difficult to give treatment orally. Keep container in the outer carton.

Diamorphine is a narcotic analgesic which acts primarily on the central nervous system and smooth muscle. You can only get diamorphine on prescription from your doctor. Oxycodone hydrochloride immediate-release preparations can be given for breakthrough pain.

Diamorphine

Hospice care of terminally ill patients has shown the importance of symptom control and psychosocial support of the patient and family. Drugs with antimuscarinic effects antagonise prokinetic drugs and, if possible, should not be used concurrently.

Acute pulmonary oedema2. Other side effects include dizziness, miosis, confusion, urinary retention, biliary spasm, orthostatic hypotension, facial flushing, vertigo, palpitations, mood changes, dry mouth, dependence, urticaria, pruritus and raised intracranial pressure.

The product is prepared by dissolving Diamorphine Hydrochloride Lyophilisate for Solution for Injection in the requisite amount of water for injection immediately before use. An antiepileptic may be added or substituted if pain persists; gabapentin and pregabalin are licensed for neuropathic pain. Dexamethasonespecial care is needed to avoid precipitation of dexamethasone when preparing it. Cyclizine is particularly likely to precipitate if mixed with diamorphine or other drugs see under Mixing and Compatibility, below Metoclopramide hydrochloride can cause skin reactions.

Prescribing in palliative care | Medicines guidance | BNF content published by NICE

Skip to main content. Analgesics can be divided into three broad classes: Diamorphine is a pain killing drug.

The use of physiological saline sodium chloride 0. Increments should be made to the dose, not to the frequency of administration. Diamorphine may be given by the syribge, intravenous or subcutaneous routes. It is kinder to give an intermittent bolus injection subcutaneously —absorption is smoother so that the risk of adverse effects at peak absorption is avoided an even better method is to use a subcutaneous butterfly needle.