The Syringe Driver: Continuous subcutaneous infusions in palliative care

The delivery of two, three, four, or even five drugs in the same syringe is now considered routine practice. A continuous subcutaneous infusion is an effective method of drug administration that is particularly suited to palliative care, where other routes are inappropriate. Palliative care patients frequently have multiple symptoms that require the use of numerous drugs; as the patient's condition deteriorates, the oral route is often no longer suitable and the syringe driver ensures continued symptom control. This route increases patient comfort as it avoids the need for repeated injections, plasma concentration levels of drugs remain constant, and it maintains the patient's sense of independence.
There have been several developments in this field since the first edition of this book published, including new devices and drugs. There is also a wealth of stability date provided, covering an extensive list of drug combinations. The book consists of four sections. The first provides an overview of syringe drivers and continuous subcutaneous infusions, including detailed set up information. The second section provides referenced information about drugs that are likely to be encountered, including certain drugs that should only be used by, or on the recommendation of, palliative care specialists. Section three provides information about symptom control in the last few days of life, concentrating specifically on the use of the syringe driver. Finally, the compatibility tables can be found in Section Four.
'The syringe driver' has proved to be an essential source of information for doctors, nurses, and pharmacists who work in palliative medicine.

Andrew Dickman is the co-author of the new edition of the Palliative Care Formulary (Twycross).