ABSTRACT
Compatibility* of specific three-drug combinations: diamorphine and antiemetic and one other ‘optional extra’drug.
Diamorphine plus Glycopyrronium Hyoscine hydrobromide Midazolam
Metoclopramide Not recommended Not recommended Compatible* Haloperidol Compatible* Compatible* Compatible* Levomepromazine Compatible* Compatible* Compatible*
Prescribe each drug individually in the ‘regular prescriptions’ section
of the drug chart, as shown here:
!!Graseby syringe drivers: mm (instead of ml) per unit timeThis type of syringe driver is common in the UK (esp in specialist palliative care settings). Infusions are given in millimetres (mm) rather than millilitres (ml) per unit time. There are 2 types: for each unit on the ‘rate’ dial, the MS16 (blue) delivers 2 mm/h, but the MS26 (green) delivers 48 mm/day. Examples of prescriptions of a syringe to be given over 24 h:
• MS16: ‘Diamorphine 60 mg over 24 h as subcutaneous infusion via syringe driver. Mix with water for injection to a length of 48 mm in syringe, set at rate of 2 mm/h.’
