Common Symptoms in Dying Patients for Which Anticipatory As-Required Prescribing is Appropriate
| Symptom | Drug | Dose for subcutaneous administration | Comment |
|---|---|---|---|
| Pain | Morphine‡ | 2–5 mg up to 2-hourly | |
| Restlessness or agitation | Midazolam | 2–5 mg up to 2-hourly | |
| Breathlessness | Morphine* | 1–2 mg up to 2-hourly | |
| Nausea and vomiting | Haloperidol | 0.5–1.5 mg up to 8-hourly | |
| Retained bronchopulmonary secretions | Glycopyrronium | 200–400μgm up to 4-hourly |
* Usual starting dose in opioid-naive patient with normal renal function; lower doses may be required for elderly or frail patients. For patients with liver or renal impairment (eGFR <50), consult local guidelines or contact palliative care team for advice.
† Opioid drug conversions are given in Table 110.8.