Ver el código de «Continuous subcutaneous infusion»

==Background==
*Abbreviation: CSCI
*Common method of medication administration in palliative medicine, especially for patients near the end of their life.
*These patients typically require parenteral medications as they lose the ability to take PO meds.
*Subcutaneous route has many advantages over IV<ref name="Gabriel">Gabriel J., The use of subcutaneous infusion in medication administration. Br J Nurs. 2013 Jul 25-Aug 7;22(14):S6, S8, S10 passim.</ref>
**No risk of phlebitis or air embolus
**Allows patient to retain more mobility (IV site typically on hand or arm; subcutaneous sites include chest, thigh, abdomen)
**More comfortable for patient
**Less susceptible to occlusion or dislodgement
**Simpler method of administration
**Seen as kinder

==Indications==
Generally used when oral route is unavailable, e.g.<ref name="Menahem">Menahem S, Shvartzman P. Continuous subcutaneous delivery of medications for home care palliative patients-using an infusion set or a pump? Support Care Cancer. 2010 Sep;18(9):1165-70.</ref>
*Weakness, drowsiness or coma
*Severe nausea/vomiting
*Severe dysphagia

==Comparative Dosing==
*[[Dexamethasone]]: 4mg orally = 4mg SC (use as stat doses)
*[[Diclofenac]]: 150mg oral = 75mg SC (use only as CSCI as tissue necrosis has been reported with stat doses)
*[[Haloperidol]]: 2mg oral = 1mg SC
*[[Hydromorphone]]: 3mg oral = 1mg SC
*[[Levetiracetam]]: 250mg oral = 250mg SC (use only as CSCI)
*Levomepromazine: 25mg oral = 12.5mg SC
*[[Methadone]]: 10mg oral = 5mg SC (typically used as a stat dose rather than via CSCI)
*[[Morphine]]: 30mg oral = 10mg SC (use as stat doses for break-through pain and via CSCI for background pain)
*[[Ondansetron]]: 8mg oral = 4mg SC (typically used as a stat dose rather than via CSCI)
*[[Oxycodone]]: 10mg oral = 5mg SC (use as stat doses for break-through pain and via CSCI for background pain)
*[[Ranitidine]]: 100mg oral = 50mg SC
*[[Valproate]]: 200mg oral = 200mg SC (use as CSCI)

==Combinations==
Mixing mediations in subcutaneous infusions can cause problems if there are drug incompatibilities that cause reactions. Look for crystallization when mixing medications.

'''Some common compatible combinations include:'''
*Morphine (or oxycodone) plus
**Haloperidol
**Levomepromazine
**Metoclopramide
**Haloperidol plus hyoscine butylbromide
**Haloperidol plus midazolam
**Haloperidol plus octreotide
**Haloperidol plus midazolam plus hyoscine butylbromide
**Haloperidol plus midazolam plus metoclopramide
**Haloperidol plus midazolam plus hyoscine butylbromide
*Fentanyl plus
**Haloperidol
**Hyoscine butylbromide
**Metoclopramide
**Haloperidol plus midazolam
**Haloperidol plus midaozolam plus hyoscine butylbromide
*Opioid-free combinations
**Haloperidol plus ondansetron
**Haloperidol plus hyoscine butylbromide plus octreotide plus ranitidine

==See Also==


==References==
<References/>

[[Category:Palliative Medicine]]