SC stat: 2.5mg–5mg
SC 24-hour syringe driver/pump: 5mg–30mg
Start at the lowest dose in the range especially in the frail or elderly.
Useful if anxiety/restlessness predominates however caution as can cause disinhibition and paradoxical agitation, particularly at high doses.
Oral PRN: 1.5mg–2.5mg
SC stat: 1.5mg–2.5 mg (0.5mg in elderly & frail)
SC 24-hour syringe driver/pump: 1.5mg–5mg
Start at the lowest dose in the range especially in the frail or elderly.
Useful if features of paranoia or psychosis are present. Also useful as an anti-emetic.
Oral PRN: 6.25mg–25mg
SC stat: 5mg–25mg
SC 24-hour syringe driver/pump: 5mg–75mg
Start at the lowest dose in the range especially in the frail or elderly as very sedative. Useful if features of paranoia or psychosis are present. Also useful as an anti-emetic. Reduces seizure threshold.
- Patients who are dying with severe agitation may be very resistant to the effects of sedatives and may need repeat doses at 30–60 minute intervals until settled
- Occasionally the combined administration of an anti-psychotic and benzodiazepine is required
- For patients requiring rapidly escalating doses of sedatives, contact the Specialist Palliative Care Team for advice
Disclaimer
This Guide is intended for use by healthcare professionals and the expectation is that they will use clinical judgement, medical, and nursing knowledge in applying the general principles and recommendations contained within. They are not meant to replace the many available texts on the subject of palliative care.
Some of the management strategies describe the use of drugs outside their licensed indications. They are, however, established and accepted good practice. Please refer to the current BNF for further guidance.
While WMPCPS takes every care to compile accurate information , we cannot guarantee its correctness and completeness and it is subject to change. We do not accept responsibility for any loss, damage or expense resulting from the use of this information.