This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Fonzo-Christe, C. Articles by Bonnabry, P. Search for Related Content PubMed PubMed Citation Articles by Fonzo-Christe, C. Articles by Bonnabry, P. Social Bookmarking                         What's this?

Subcutaneous administration of drugs in the elderly: survey of practice and systematic literature review

Caroline Vukasovic

Anne-Florence Wasilewski-Rasca

Pascal Bonnabry

Pharmacy, University Hospitals of Geneva (HUG)

Objectives and method: Survey of subcutaneous drug use and hypodermoclysis with a standardized questionnaire to 27 nursing teams and 52 physicians in a geriatric hospital department (404 beds). Evaluation of license status (CH, F, D and UK) and systematic literature review of 34 drugs used in the geriatric setting. Results: Subcutaneous route is used daily with drugs and fluids mostly for patients in palliative care (83%) or who are dehydrated (54%) when oral or IV administration is impossible (73%, 68% respectively). Morphine (98%), haloperidol (90%), furosemide (69%) and hydromorphone (56%) by bolus (36%) or slow injection over 5 min (82%) are the main drugs used and NaCl 0.9% (95%), and glucose 5%/NaCl 0.9% (31%) are commonly used for rehydration. Among the 34 drugs reviewed, only 13 (38%) are licensed for subcutaneous use in CH, UK, F or D, and only morphine (14 articles of 68) and rehydration (six articles) are evaluated in high level studies. Haloperidol and furosemide are used off-label and there are no well-designed studies supporting their subcutaneous use. Conclusion: There is a lack of information on drugs widely used by subcutaneous route in the elderly. In that context, physicians carry responsibility for the prescription.

Key Words: aged • drug utilization • fluid therapy • injections • palliative care • subcutaneous

Palliative Medicine, Vol. 19, No. 3, 208-219 (2005)
DOI: 10.1191/0269216304pm1006oa


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?