Thereafter, the dose should be adjusted with careful assessment of the pain, and the use of adjuvant analgesics should also be considered. The equivalent subcutaneous dose of diamorphine hydrochloride is about one-third of the oral dose of morphine. You are likely to need to slowly reduce the amount you take. Palliative care is an approach that improves the quality of life of patients and their families facing life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial, and spiritual. Dry mouth 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 miconazole , alternatively, fluconazole can be given by mouth. Hiccup Hiccup due to gastric distension may be helped by a preparation incorporating an antacid with an antiflatulent. Symptom control Several recommendations in this section involve unlicensed indications or routes.
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Nausea and vomiting are common in patients with advanced cancer. Read about diamorphine, how you have it and other important information about taking this painkiller.
DIAMORPHINE HYDROCHLORIDE | Drug | BNF content published by NICE
Symptom control Several recommendations in this section involve unlicensed indications or routes. Conversion ratios vary and these figures are a guide only. You have it for moderate to severe pain.
Intractable cough may be relieved by moist inhalations or by regular administration of oral morphine. They check your levels of blood cells and other substances in the blood. The standard dose of a strong opioid for breakthrough pain is usually one-tenth to one-sixth of the regular hour dose, repeated every 2—4 hours as required up to hourly may be needed if pain is severe or in the last days of life.
If breakthrough pain occurs give a subcutaneous preferable or intramuscular injection equivalent to one-tenth to one-sixth of the total hour subcutaneous infusion dose.
The following hour oral doses of morphine are considered to be approximately equivalent to the buprenorphine and fentanyl patches shown, however when switching due to possible opioid-induced hyperalgesia, reduce the calculated equivalent dose of the new opioid by one-quarter to one-half.
By slow intravenous injection For Adult 1. 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.
A corticosteroid such as dexamethasone may help, temporarily, if there is an obstruction due to tumour. Levomepromazine is licensed to treat pain in palliative care—this use is reserved for distressed patients with severe pain unresponsive to other measures seek specialist advice.
You can have diamorphine as an injection into the syrineg tissue just under the skin. Methadone hydrochloride linctus should be avoided because it has a long duration of action and tends to accumulate. Gastro-intestinal pain The pain of bowel colic may be reduced by loperamide hydrochloride.
Review pain management if rescue analgesic is required frequently twice daily or more. Overview Palliative care is an approach that diamorphiine the quality of life of patients and their families facing life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial, and spiritual. Patients with advanced cancer may not sleep because of discomfort, cramps, night sweats, joint stiffness, or fear.
Hiccup Hiccup due to gastric distension may be helped by a preparation incorporating an antacid with an antiflatulent. Convulsions If a patient has previously been receiving an antiepileptic drug or has a primary or secondary cerebral tumour or is at risk of convulsion e.
Codeine phosphate or tramadol hydrochloride can be considered for moderate pain. Neuropathic pain Patients with neuropathic pain may benefit from a syringge of a tricyclic antidepressant.
Pain Pain management in palliative care is syrringe on achieving control of pain by administering the right drug in the right dose at the right time. Hyoscine butylbromide Hyoscine hydrobromide Levomepromazine Metoclopramideunder some conditions infusions containing metoclopramide become discoloured; such solutions should be discarded.
Changes in practice in the use of subcutaneous diamorphine via syringe driver.
During the titration phase the initial dose is based on the previous medication used, the severity of the pain, and other factors such as presence of renal impairment, increasing age, or frailty.
Morphine is also available for rectal administration as suppositories; alternatively oxycodone hydrochloride suppositories can be obtained on special order.
Pain control Diamorphine hydrochloride is the preferred opioid since its high solubility permits a large dose to be given in a small volume see under Mixing and Compatibility, below. Ketamine is sometimes used under specialist supervision for neuropathic pain that responds poorly to opioid analgesics. These antimuscarinics are generally given every 4 hours when required, but hourly use is occasionally necessary, particularly in excessive respiratory secretions.
Talk to your doctor or nurse before you change your dose. The table shows approximate equivalent doses of morphine and diamorphine diamoprhine. Each patient should be assessed on an individual basis. Bowel colic and excessive respiratory secretions may be reduced by a subcutaneous injection of hyoscine hydrobromidehyoscine butylbromideor glycopyrronium bromide.
The first dose of the modified-release preparation is sryinge with, or within 4 hours of, the last dose of the immediate-release preparation. Or you might have diamorphine as tablets.