Med‎ > ‎


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

Andreas Jostel,
20 Jan 2010, 02:45