Abstract
The use of the subcutaneous route for the administration of medications in Palliative Care (PC) is a very interesting route when the oral route is not available. The use of infusers for continuous infusion allows the control of symptoms in a simple way. In many cases it is necessary to administer more than one drug, so mixing them in the same infuser is the best alternative. However, there are few published data on the stability of mixtures, and even less if we focus on data on the physicochemical stability of drug mixtures in infuser-type delivery systems and stored in conditions of temperature and light similar to those of practice assistance. The objective of this review is to analyze the available evidence on the stability of the mixtures identified through bibliographic review in tertiary sources (Technical file, book Trissel's Stability of Compounded Formulation, Micromedex, stabilis.org, pallcare.info and palliativedrugs.com). This consultation is completed with a bibliographic search in the main biomedical databases: EMBASE and Pub Med and with a review of the primary sources of interest resulting from the previous search.
Highlights
There are few published data on the stability of mixtures, and even less if we focus on data on the physicochemical stability of drug mixtures in infuser-type delivery systems and stored in conditions of temperature and light similar to those of practice assistance
The administration of drug mixtures in the infuser by subcutaneous route is of interest for non-admitted patients who receive assistance from home support teams, in whom access to the intravenous route is difficult
The drug mixtures that arouse the most interest to the professionals surveyed are those that contain morphine and / or midazolam
Summary
The aging of the population and the growing number of people with chronic degenerative diseases and cancer represent a major challenge for health services worldwide and pre-eminently in developed societies. Many of these patients, at the end of their life, suffer intense suffering and require health and social care that involves all areas of care. The Palliative Care (PC) movement started in the UK during the 1970s (Hospice Movement) and spread internationally At this time, Cicely Saunders was the first healthcare provider to guide her professional work towards the search for specific solutions for the requirements of patients with terminal illness, which gave rise to the philosophy and principles that are known today as PC. Christopher’s Hospice, which can be considered the cradle of the modern Hospice Movement and PCs
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