Palliative Care Medications
Palliative care medications form part of the holistic approach to supporting people with palliative care needs. Medications may be needed to manage symptoms associated with a palliative diagnosis such as pain, nausea, vomiting and shortness of breath.
In a palliative care approach, giving medications should be as simple and unobtrusive as possible. The medications are prescribed depending on the need of each individual, and may involve using a variety of routes of administration. Depending on the individual need, the majority of patients should be able to receive their medications in their preferred place of care. That may be at home, hospital or in hospice setting.
Please see links below to Patient Information Leaflets for some palliative care medications:
- Alfentanil
- Ketamine
- Levomepromazine
- Opioids (such as Oxycodone or Fentanyl)
- Parecoxib (also known as Dynastat)
Syringe Pumps
Syringe pumps (or sometimes known as syringe drivers) are often used by palliative care teams to manage symptoms by administering medicines subcutaneously (applied under the skin). This route can be useful for patients who are unable to manage or tolerate oral medication, or where absorption from the gut is compromised. Ambulatory syringe pumps are portable battery-operated devices for delivering medication by continuous subcutaneous infusion over 24 hours. They are useful when small volumes of drugs need to be infused at a slow rate and their compact design allows patients to be independent as much as possible. Syringe pumps offer a safe and alternative route for delivering medicine when the oral route cannot be used. Further information about the use of Syringe Pumps can be downloaded here.
Stopping unnecessary medications
People with palliative care needs are often on a range of long-term medications which may have been prescribed with the aim of managing or controlling other health conditions. Medications prescribed for any reason should always be considered in terms of the risks and benefits for the patient. It is important to think about potential side effects or interactions between medications. As the clinical picture of the patient changes so can the appropriateness of the medications prescribed. Decisions about which medications to stop should be made by balancing the likely benefit, with risks associated with stopping the medications to manage existing conditions.
‘Just In Case’ Medication
‘Just in Case’ medications (also known as ‘anticipatory prescribing’) are medications which are prescribed to help control symptoms associated with the last few days or hours of life if needed. Sometimes it can take time for a doctor to prescribe medicines, or for your pharmacy to order them, especially during out of hours periods. By having the appropriate medicines prescribed in advance and available wherever the patient is being cared for, it reduces the likelihood of delays in accessing the correct medicine. This means you don’t need to worry about trying to get them if/when they are needed.
The health care professionals in charge of you or your loved ones care will discuss with you if they feel there is a role for ‘Just in Case’ medicines to be prescribed. They can help decide which medicines might be useful depending on each individual situation. ‘Just in Case’ medicines are normally given by injection and are administered by a nurse or doctor when/if needed.