Buprenorphine and Alfentanil are safe to use in patients with renal impairment. No dose adjustments in Transdermal preparations. Morphine, Diamorphine and codeine derivatives which produce toxic metabolites accumulate in renal failure
About: Always check the BNF link here
Nausea and vomiting
Dose range:You must check with BNF or drug datasheet
Name Starting Dose Frequency Route Haloperidol 0.5-1.0 mg 8-hourly SC/IV/PO Levomepromazine 2.5 mg to 5mg 12-hourly SC
Opioid for pain and/or breathlessness (for opioid naive patient)
Dose range: titrate to symptoms
Name Starting Dose Frequency Route Morphine (Oramorph) 5 mg 4-hourly PRN PO Morphine (Modified release) 10 mg 12-hourly PO Morphine 2-5 mg 4 hrly SC Morphine 20 mg Over 24 hrs Syringe driver SC Diamorphine 1.25-2.5 mg 4 hrly SC Diamorphine 10 mg Over 24 hrs Syringe driver SC Buprenorphine standard dose Used in renal failure Alfentanil 0.5 to 1 mg Over 24 hrs Used in stage 4/5 renal failure. Syringe driver SC Alfentanil 0.1 mg Used for breakthrough Used in stage 4/5 renal failure. S/C Anti-secretory for respiratory secretions
Anxiolytic sedative for anxiety or agitation or breathlessness
Myoclonus or muscle stiffness or spasm or seizure
Terminal agitation
References
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Palliation prescribing
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