Medications and Options
 MedicationDose and route
BreathlessnessSee Attached Protocol 
If severe, use opioid (morphine or hydromorphone).
Agitated deliriumMild to moderate 
 Haloperidol2 mg PO q4h
  1-2 mg Subcut q4h PRN
 Methotrimeprazine 12.5-25mg PO/SC q4h PRN
 OlanzapinePO- Oral dissolving tablet 5-10mg q12h PRN
  Subcut 5-10mg q12h PRN (using IM formulation)*
 Loxapine 5-10mg SC q4h PRN
 Quetiapine25-50mg po q6h PRN
 Risperidone0.5-1.0 PO q12h PRN
 Midazolam 1-2mg Subcut or IV q1h PRN
 Lorazepam1-2mg PO/SL/IV q1h PRN
Palliative sedation for intractable symptom like uncontrolled dyspnea or agitation
Contact Palliative Care Service for Advice 
Anxiety Clonazepam0.5-2mg PO q8h PRN
 Lorazepam0.5-2 mg PO/SL q2-4hrs PRN
Airway secretionsScopolamine0.4-0.6mg Subcut q4h PRN
 Glycopyrrolate0.4mg Subcut q4h PRN
Pulmonary edemaFurosemide10-40mg IV or Subcut
CoughMild to moderate 
 Dextromethorphan10mg-20mg PO q 4-6 hrs PRN
 Hydrocodone5mg PO q 4-6hrs PRN
 morphine2.5 – 5 mg PO q4hrs (SC dose is ½ of oral dose).
  If already on opioid, titrate dose.
 hydromorphone0.5 – 1 mg PO Q4H (SC dose is ½ of oral dose)
  If already on opioid, titrate dose
PainMorphine (a very good first-line opioid)See clinical guidelines
 HydromorphoneSee clinical guidelines
Nausea vomitingMetoclopramide5mg -10mg subcut q4hrs PRN (PO if not severe)
 Ondansetron4mg – 8mg subcut/IV TID PRN (PO if not severe)
 Haloperidol 0.5mg – 1mg PO or subcut q4hrs* PRN (PO if not severe)*

If shortage of any above medications, or if you need any advice, contact the Palliative Care Support Team (See Box …)