Abstract:
:Parenteral administration of mixtures of morphine with other drugs has become common practice in palliative care. Such mixtures are sometimes found to be incompatible but compatibility data are scarce. An attempt was made to develop a quick and simple investigation strategy to obtain complete information on the compatibility of two drugs. This strategy was then used to study the physical and chemical compatibility of morphine HCl with alizapride HCl, atropine sulphate, dexamethasone sodium phosphate, hyoscine butylbromide, metoclopramide HCl, octreotide lactate, ranitidine HCl and hyoscine hydrobromide. These compatibility data are presented in such a way that they are easy to use in clinical practice. The investigation strategy outlined here allows the collection of complete information on the compatibility of morphine with another drug by studying a limited number of carefully selected mixtures per combination. The mixtures to be studied are selected using a scheme in which all possible mixtures prepared by mixing morphine solutions of varying concentrations with a drug solution in different volume ratios can be visualized. Applying this strategy to the eight combinations revealed, except for ranitidine HCl, no physical (visual) or chemical (HPLC; >90%) incompatibility in any of the mixtures studied for seven days at 22 and 32 degrees C. This indicates that all possible mixtures of these drug solutions with morphine HCl are compatible. For the combination with ranitidine incompatibility was observed only when using morphine HCl solutions containing >40 mg/ml and at certain ratios (drug/morphine HCl [D/M]: 4/42, 10/6 and 8/8, v/v), but all physically compatible mixtures were chemically stable (>90%). Studying extra mixtures in addition to those required to be studied according to the strategy revealed no discrepancies for any of the eight combinations studied. Adaptation of the layout of the scheme and the design of a decision tree resulted in an easy tool to check compatibility in daily practice. The scheme designed in this study is a useful tool for research and for daily practice. It simplifies and thereby encourages investigation of the compatibility of drugs. The availability of data on the physical as well as chemical compatibility in daily practice will contribute to a better quality of the mixtures used in palliative care and help to avoid complications and inadequate symptom control.
journal_name
Palliat Medjournal_title
Palliative medicineauthors
Vermeire A,Remon JP,Schrijvers D,Demeulenaere Pdoi
10.1191/0269216302pm542oasubject
Has Abstractpub_date
2002-09-01 00:00:00pages
417-24issue
5eissn
0269-2163issn
1477-030Xjournal_volume
16pub_type
指南,杂志文章,实务指引abstract::This study reports the process and results of a psychometric evaluation of a clinical audit tool, the Support Team Assessment Schedule (STAS), used to measure outcomes of palliative care. The STAS was developed in London, UK to audit community palliative care services provided by a support team. The purpose of this st...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/026921600677786382
更新日期:2000-01-01 00:00:00
abstract::The purpose of this study was to further validate a novel instrument to measure satisfaction with end-of-life care, called the Canadian Health Care Evaluation Project (CANHELP) questionnaire. Data were collected by a cross-sectional survey of patients who had advanced, life-limiting illnesses and their family caregive...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216310373168
更新日期:2010-10-01 00:00:00
abstract::A survey of all district health authorities in England was conducted in order to describe current patterns of needs assessment and contract setting for palliative care services. Outcome measures included the completion of needs assessments in the past five years, the type of data used for needs assessment, and recomme...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/026921639500900403
更新日期:1995-10-01 00:00:00
abstract::This study looked at the efficacy of drug treatment in managing death rattle in a 30-bedded specialist palliative care unit. The study was conducted in two phases. In the first, patients received hyoscine hydrobromide as the antimuscarinic; glycopyrrolate was used in the second phase. The patients in the two phases we...
journal_title:Palliative medicine
pub_type: 临床试验,杂志文章
doi:10.1191/026921601678320313
更新日期:2001-07-01 00:00:00
abstract::The main focus of palliative care services is to improve patients' quality of life (QOL). The potential value of assessment of QOL in palliative care is being increasingly recognized. The McGill Quality of Life questionnaire (MQOL) is designed specifically for palliative care patients, but its cross-cultural validity ...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/026921601680419438
更新日期:2001-09-01 00:00:00
abstract:BACKGROUND:Hospitalizations in patients with metastatic cancer occur commonly at the end of life but have not been well-described in individuals with metastatic breast cancer. AIM:To describe the reasons for admission and frequency of palliative care and hospice utilization in hospitalized patients with metastatic bre...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216316637238
更新日期:2016-10-01 00:00:00
abstract:BACKGROUND:in community studies the prevalence of depression is higher in women than men; however, in palliative care settings this relationship is usually less strong, absent or reversed. AIM:to identify reasons for excess depression among men receiving palliative care. DESIGN:cross-sectional study. SETTING/PARTICI...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216311416035
更新日期:2012-07-01 00:00:00
abstract:BACKGROUND:Specialist palliative care (SPC) services in Ireland are well developed by international standards. However, standardized information on all patients of SPC services is not collected so the proportion of patients seen with a noncancer diagnosis is just an estimate at 5%. AIMS:To describe Irish SPC services'...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216307084609
更新日期:2008-01-01 00:00:00
abstract::Access to palliative care (PC) is a major need worldwide. Using hospital charts of all patients who died over one year (April 2008-March 2009) in two mid-sized hospitals of a large Canadian city, similar in size and function and operated by the same administrative group, this study examined which patients who could be...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216311408992
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:The Surprise Question ("Would I be surprised if this patient were to die within the next 12 months?") is widely used to identify palliative patients, though with low predictive value. To improve timely identification of palliative care needs, we propose an additional Surprise Question ("Would I be surprised ...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216320986720
更新日期:2021-01-11 00:00:00
abstract:BACKGROUND:Globally, most care for people with life-limiting illnesses is provided by informal caregivers. Identifying characteristics of caregivers that may have unmet needs and negative outcomes can help provide better support to facilitate adjustment. AIM:We compared characteristics, expressed unmet needs and outco...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216316663855
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:Approximately one-third of rapid response team consultations involve issues of end-of-life care. We postulate a greater occurrence in patients with a life-limiting illness, in whom the opportunity for advance care planning and palliative care involvement should be offered. AIMS:We aim to review the characte...
journal_title:Palliative medicine
pub_type: 杂志文章,多中心研究
doi:10.1177/0269216314560802
更新日期:2015-04-01 00:00:00
abstract::Restructuring health care in Canada has emphasized the provision of ambulatory and home-based palliative care. Acquiring economic evidence is critical given this trend and its tremendous demands on family caregivers. The purposes of this study were: 1) to comprehensively assess the societal costs of home-based palliat...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216310364877
更新日期:2010-07-01 00:00:00
abstract::Research into the burden of illness has focused predominantly on family caregivers, with little consideration of the other side of the caregiving relationship-care recipients' perspectives on having become a 'burden to others'. However, there is now a small but growing body of evidence to suggest that worry about crea...
journal_title:Palliative medicine
pub_type: 杂志文章,评审
doi:10.1177/0269216307076345
更新日期:2007-03-01 00:00:00
abstract::Although anecdotal reports suggest nebulized lignocaine may help breathlessness in patients with cancer this has not been examined formally. We report a pilot study comparing nebulized lignocaine 100 mg and 200 mg with saline in six patients with cancer who were breathless at rest. Nebulized lignocaine was well tolera...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/026921639400800106
更新日期:1994-01-01 00:00:00
abstract::The Research Network of the European Association for Palliative Care (EAPC) performed a survey of 3030 cancer patients from 143 palliative care centres in 21 European countries. The survey addressed pain intensity and the use of non-opioid analgesics, adjuvant analgesics and opioids. Patients were treated with analges...
journal_title:Palliative medicine
pub_type: 杂志文章,多中心研究
doi:10.1191/0269216305pm1054oa
更新日期:2005-09-01 00:00:00
abstract::The European Association for Palliative Care recommendation for starting morphine for cancer pain is dose titration with immediate release (IR) oral morphine given every 4 h with additionally doses for breakthrough pain. As part of a EU 6th framework programme to revise the guidelines we review the evidence regarding ...
journal_title:Palliative medicine
pub_type: 杂志文章,评审
doi:10.1177/0269216310386280
更新日期:2011-07-01 00:00:00
abstract::The relationship between opioid dose, dantron dose, bowel function and physical functioning (measured with the modified Barthel Index) was determined in a sample of 50 inpatients with advanced cancer. Data were collected prospectively from chart review and patient interviews one week after admission to allow for proto...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/0269216303pm773oa
更新日期:2003-07-01 00:00:00
abstract:BACKGROUND:The perspectives of patients and relatives are important in the improvement of the quality of health care. However, the quality of end-of-life care has not been systematically evaluated in Scandinavia. AIM:To develop or adapt and subsequently validate a questionnaire assessing the quality of end-of-life car...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216317740274
更新日期:2018-04-01 00:00:00
abstract::This study compares terminally ill patients and their family caregivers in terms of the physical and emotional status of the patients, the adequacy of the support provided for the patients and where the patients would be most appropriately placed during the last stage of their lives. Patients and caregivers shared sim...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/026921639300700204
更新日期:1993-01-01 00:00:00
abstract::To be able to distinguish end-stage palliative sedation from euthanasia without having to refer to intentions that are difficult to verify, physicians must be able to manage palliative sedation appropriately (i.e., see that death is not hastened as a result of disproportionate medication). In the present study, we ass...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216308091867
更新日期:2008-07-01 00:00:00
abstract:BACKGROUND:Primary care has the potential to play significant roles in providing effective palliative care for non-cancer patients. AIM:To identify, critically appraise and synthesise the existing evidence on views on the provision of palliative care for non-cancer patients by primary care providers and reveal any gap...
journal_title:Palliative medicine
pub_type: 杂志文章,评审
doi:10.1177/0269216314531999
更新日期:2014-10-01 00:00:00
abstract:BACKGROUND:Sedatives are frequently used towards the end of life. However, there is scarce information when their use is labelled as 'palliative sedation'. AIM:To assess the use and labelling of 'continuous administration of sedatives within the last 7 days of life', based on objective operational criteria, on a palli...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216318764095
更新日期:2018-07-01 00:00:00
abstract::We determined the relationship between symptom severity and distress for multiple cancer symptoms, and examined patient demographic influences on severity and distress in advanced cancer. A Cochran-Armitage trend test determined whether symptom distress increased with severity. Chi-square, Fisher's exact test and logi...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216309356380
更新日期:2010-04-01 00:00:00
abstract:BACKGROUND:We have undertaken a systematically searched literature review using a realist logic of analysis to help synthesise the diverse range of literature available on hospice at home services. AIM:To find out in the existing literature what features of hospice at home models work best, for whom and under what cir...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216319867424
更新日期:2020-01-01 00:00:00
abstract::Homeless persons tend to die younger than the housed population and have complex, often unmet, end-of-life care needs. High levels of illicit drug use among this population are a particular challenge for health and social services professionals involved in end-of-life care services delivery. This article explores the ...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216311402713
更新日期:2012-06-01 00:00:00
abstract::The subject of communication between palliative care physicians and their patients regarding their diagnosis and prognosis has not been extensively researched. The purpose of this survey was to compare the attitudes and beliefs of palliative care specialists regarding communication with the terminally ill in Europe, S...
journal_title:Palliative medicine
pub_type: 杂志文章,多中心研究
doi:10.1191/026921600674582192
更新日期:2000-07-01 00:00:00
abstract:BACKGROUND:Clinical pathways aim to ensure that individuals receive appropriate evidence-based care and interventions, with the Liverpool Care Pathway for the Dying Patient focusing on end of life. However, controlled studies of the Liverpool Care Pathway for the Dying Patient, particularly outside of cancer settings, ...
journal_title:Palliative medicine
pub_type: 杂志文章,随机对照试验
doi:10.1177/0269216315588007
更新日期:2016-01-01 00:00:00
abstract::Objective of this study is to examine physicians' practices regarding information disclosure to terminally ill patients and to their relatives, without informing the patient. A questionnaire had been sent to a random sample of 3014 Belgian physicians from different specialties frequently involved in end-of-life care. ...
journal_title:Palliative medicine
pub_type: 杂志文章,多中心研究
doi:10.1177/0269216308102043
更新日期:2009-06-01 00:00:00
abstract::It is important to support general practitioners (GPs) in maintaining and developing their palliative care skills as most of the final year of a patient's life is spent at home under the care of the primary health care team. The training needs and uptake of GPs have been explored, but little is known about how GP educ...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/026921601678576176
更新日期:2001-05-01 00:00:00