Chemical compatibility of drug combinations used in end of life care.
|FollowUp||University of Liverpool|
A continuous subcutaneous infusion (CSCI) is an effective method of drug administration that is commonly encountered in palliative medicine. When the oral route is no longer available, the use of a CSCI is the preferred method of drug administration to maintain symptom control. A syringe driver, or pump, is used to deliver a CSCI. Despite the number of potential drug combinations likely to be encountered in a CSCI exceeding 2000, only a handful of combinations have been studied for chemical compatibility. The aim of this project is to develop an authoritative national guide detailing the chemical compatibility of a selection of drug combinations commonly used for symptom management during the last months and days of life, including pain, nausea and vomiting, terminal secretions and terminal agitation. The results of this study will be immediately applicable to the clinical setting; a mixture will either be chemically compatible or not. In the clinical situation, it is generally accepted that a greater than 10% loss in concentration is considered significant. Should any combination show a concentration loss of more than 10%, the practitioner would be advised to choose an alternative treatment. The information gained by undertaking this work would have both national and international appeal and has the potential to be of great importance for palliative medicine. Healthcare professionals will be able to use data from this study to inform their clinical decision making and ensure the best possible end-of-life care.
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