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Palliative Medicine
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Drugs used in combination in the syringe driver-a survey of hospice practice

Ian Johnson

Honorary Consultant in Palliative Medicine

Susan Patterson

The Leicestershire Hospice, Leicester

A survey of hospices in the UK revealed a wide range of drugs being given in combination by subcutaneous infusion. The reported maximum doses were, in general, higher than those used in previous in vitro studies of drug compatibility. Very wide interhospice variation in the maximum doses of many of the drugs was found. Potential problems relating to the choice of diluent, protection of drugs from light and the method of setting up different models of syringe driver are discussed. The great majority of syringe driver infusions are given over a period of less than 48 hours, but it is possible to set machines to run for much longer periods without refilling. As the number and variety of drugs used in combination in the syringe driver increase, so the need for more studies of the compatibility of these drugs becomes more pressing to avoid the potential for adverse interaction. Whilst these results report current hospice practice they must not be regarded as an endorsement of such practice, but rather as a source of information for those concerned with finding out more about the compatibility of drugs in combination in the syringe driver.

Key Words: drug incompatibility • drug stability • palliative treatment • parenteral infusion • subcutaneous administration

Palliative Medicine, Vol. 6, No. 2, 125-130 (1992)
DOI: 10.1177/026921639200600206
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