DRUG INFUSORS IN PALLIATIVE MEDICINE - A SWEDISH INQUIRY

The use of drug infusers is common in palliative care. Knowledge about the drugs being used and the handling of drug mixtures is insufficien t and poorly documented. To clarify this practice, a questionnaire was sent to all departments of pain/anesthesiology and oncology, and to a ll home-care teams and palliative care units/hospices in Sweden (N = 1 56). The questions concerned specific qualities of the drug infusors a nd the different drugs and drug mixtures used by subcutaneous (SC) and intravenous (IV) administration. A total of 110 (70%) of the question naires were returned. A majority of the respondents reported the use o f one or more Of three different infusors. Morphine was used ill 73% o f all single drug infusions. Dosages ranged from 30 mg/24 hr to 5000 m g/24 hr. The most common drug mixture was morphine/haloperidol (22% of all drug mixtures). As many as three drugs were used in combination. The most frequent indication to switch from oral administration to par ental administration was gastrointestinal disorders such as swallowing difficulties, nausea, vomiting or bowel obstruction. In Sweden, there is extensive clinical experience administering opioids in infusors, b ut experience varies for, different drug mixtures. There are few clini cal and pharmacological investigations to support this practice and fu rther studies are needed. (C) U.S. Cancer Pain Relief Committee, 1998.