ICP for the Care of the Dying (PAT)

• Terminal Restlessness and Agitation (incl Myoclonus)
• Midazolam 2.5-5mg s/c q[1-]4h PRN -> 10-60mg/24h s.c. via syringe driver
• Pain
• Diamorphine 2.5-5mg s/c q[1-]4h PRN [=Morphine 3.75-7.5mg] -> 10-20mg/24h [=Morphine 15-30mg] s.c. via syringe driver (higher doses if on regular opioids previously)
• Nausea and vomiting
• Levomepromazine 5mg s/c tds PRN -> 5-10mg/24h via syringe driver
• Respiratory Tract Secretions
• Glycopyrronium 0.2mg s/c stat -> 0.6-1.2mg/24h s.c. via syringe driver
• Breathlessness
• consider nebulized bronchodilators for bronchospasm, diuretics for heart failure, but first line: opioids