Palliative Care Guidelines - NHS Lanarkshire

Palliative Care Guidelines: McKinley T34 syringe pump drug compatibility & stability chartsTable 4: Subcutaneous Alfentanil infusion in a McKinley T34 Syringe PumpDiluent: Water for injections• These are not clinical doses to prescribe. Most patients do not need such high doses.Read the relevant guidelines.• Use this table to check for concentrations that are stable.• Refer to the relevant guideline to obtain the usual dose range for each of the medications. Usethe minimum effective dose and titrate according to response.Drug CombinationConcentrations of two drug combinations that are physically stableAlfentanilCyclizineAlfentanilGlycopyrronium bromideAlfentanilHaloperidolAlfentanilHyoscine butylbromideAlfentanilHyoscine hydrobromideAlfentanilLevomepromazineAlfentanilMetoclopramideAlfentanilMidazolamAlfentanilOctreotide17ml in 20ml syringe4mg150mg5.5mg1200 micrograms7.5mg10mg5.5mg120mg7.5mg1200 micrograms7.5mg40mg2.5mg60mg3.5mg50mg6mg800 micrograms22ml in 30ml syringe5mg150mg8mg1200 micrograms10mg10mg8mg120mg10mg1200 micrograms10mg50mg3mg80mg5mg60mg8mg900 microgramsDrug CombinationConcentrations of three drug combinations that are physically stableAlfentanilHaloperidolMidazolamAlfentanilHyoscine butylbromideLevomepromazineAlfentanilMetoclopramideMidazolamAlfentanilLevomepromazineMidazolam17ml in 20ml syringe4.5mg5mg35mg5mg120mg25mg3mg35mg20mg3.5mg80mg30mg22ml in 30ml syringe6mg5mg45mg7.5mg120mg25mg3.5mg45mg30mg5mg100mg40mgKey references1. Dickman A: The syringe driver: continuous subcutaneous infusions in palliative care. 2nd Edition, 2004. OUP.2. Palliative care drug information online http://www.palliativedrugs.com/Further reading: http://www.palliativecareguidelines.scot.nhs.uk4 Issue date: January 2009 Review date: March 2012 © NHS Lanarkshire