Gastric distension pain due to pressure on the stomach may be helped by a preparation incorporating an antacid with an antiflatulent and a prokinetic such as domperidone before meals. Forms available from special-order manufacturers include: Diamorphine has been administered in reduced doses to children with neoplastic disease when it becomes difficult to give treatment orally. Antiemetic therapy should be reviewed every 24 hours; it may be necessary to substitute the antiemetic or to add another one. Drugs with antimuscarinic effects antagonise prokinetic drugs and, if possible, should not be used concurrently.
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Naloxone may also be given by continuous intravenous infusion, 2 mg diluted in ml, at a rate adjusted to the patient’s response.
Diamorphine Hydrochloride BP 100 mg Lyophilisate for Solution for Injection
Dysphagia A corticosteroid such as dexamethasone may help, temporarily, if there is an obstruction due to tumour. Patients with neuropathic pain may benefit from a trial of a tricyclic antidepressant. Although drugs can usually be administered by mouth to control the symptoms of advanced cancer, the parenteral route may sometimes be necessary. Specialist palliative care is available in most areas as day hospice care, home-care teams often known as Macmillan teams diamorpuine, in-patient hospice care, and hospital teams.
By slow intravenous injection For Adult 1. Metoclopramide hydrochloride has a prokinetic action and is used by mouth for nausea and vomiting associated with gastritis, gastric stasis, and functional bowel obstruction.
Dry mouth may be relieved by good mouth care and measures such as chewing sugar-free gum, sucking ice or pineapple chunks, or the use of artificial saliva ,dry mouth associated with candidiasis can be treated by oral preparations of nystatin or miconazolealternatively, fluconazole can be given by mouth. Avoid use or reduce dose; opioid effects increased and dksage increased cerebral sensitivity.
Administration during labour may cause respiratory depression in the neonate and gastric stasis during labour, increasing the risk of inhalation pneumonia.
Drugs with eosage effects antagonise prokinetic drugs and, if possible, should not be used concurrently. Syrinte equivalent parenteral dose of morphine subcutaneous, intramuscular, or intravenous is about half of the oral dose. When prescribing this medicine, patients should be told: Show table of contents Hide table of contents 1. The reconstituted lyophilisate is a clear solution. By slow intravenous injection, one quarter to one half the corresponding intramuscular dose. Transdermal route Transdermal preparations of fentanyl and buprenorphine are available, they are not suitable for acute pain or in patients whose analgesic requirements are changing rapidly because the long time to steady state prevents rapid titration of the dose.
DIAMORPHINE HYDROCHLORIDE | Drug | BNF content published by NICE
If affected patients should not drive or use machines. Subcutaneous infusion solution should be monitored regularly both to check for precipitation and discolouration and to ensure that the infusion is running at the correct rate. Hiccup due to gastric distension may be helped by a preparation incorporating an antacid with an antiflatulent.
To minimise the risk of infection no individual subcutaneous infusion solution should be used for longer than 24 hours. Company contact details Accord-UK Ltd.
Repeated administration of intramuscular injections can be difficult in a cachectic patient. Haloperidol and levomepromazine can both be given as a subcutaneous infusion but sedation can limit the dose of levomepromazine.
Gastro-intestinal pain The pain of bowel colic may be reduced by loperamide hydrochloride. Indications for the parenteral route are: A corticosteroid, such as dexamethasonemay also be helpful if there is bronchospasm or partial obstruction.
Prophylactic treatment with phenytoin or carbamazepine should be considered. Hyperpyrexia and CNS toxicity have been reported when opioid analgesics are used with selegiline.
By intramuscular injection, or by subcutaneous injection. Parenteral route The equivalent parenteral dsoage of morphine subcutaneous, intramuscular, or intravenous is about half of the oral dose.
Prescribing in palliative care | Medicines guidance | BNF content published by NICE
As diamorphine has a respiratory depressant effect, care should be taken when giving the drug to the very young diiamorphine the elderly and a lower starting dose than normal is recommended.
Therapeutic doses unlikely to affect infant; withdrawal symptoms in infants of dependent mothers; breast-feeding not best method of treating dependence in offspring. Provided that there is evidence of compatibility, selected injections can be mixed in syringe drivers.
If treatment continues for more than 24 hours it may be appropriate to use a syringe driver Burne R, Hunt A, Palliative Medicine1, Children and Elderly: This class dizmorphine medicine is in the list of drugs included in regulations under 5a of the Road Traffic Act Cyclizine is given by mouth.