| Medications and Options | ||
| Medication | Dose and route | |
| Breathlessness | See Attached Protocol If severe, use opioid (morphine or hydromorphone). | |
| Agitated delirium | Mild to moderate | |
| Haloperidol | 2 mg PO q4h | |
| 1-2 mg Subcut q4h PRN | ||
| Methotrimeprazine | 12.5-25mg PO/SC q4h PRN | |
| Olanzapine | PO- Oral dissolving tablet 5-10mg q12h PRN | |
| Subcut 5-10mg q12h PRN (using IM formulation)* | ||
| Loxapine | 5-10mg SC q4h PRN | |
| Quetiapine | 25-50mg po q6h PRN | |
| Risperidone | 0.5-1.0 PO q12h PRN | |
| Severe | ||
| Midazolam | 1-2mg Subcut or IV q1h PRN | |
| Lorazepam | 1-2mg PO/SL/IV q1h PRN | |
| Palliative sedation for intractable symptom like uncontrolled dyspnea or agitation Contact Palliative Care Service for Advice | ||
| Anxiety | Clonazepam | 0.5-2mg PO q8h PRN |
| Lorazepam | 0.5-2 mg PO/SL q2-4hrs PRN | |
| Airway secretions | Scopolamine | 0.4-0.6mg Subcut q4h PRN |
| Glycopyrrolate | 0.4mg Subcut q4h PRN | |
| Pulmonary edema | Furosemide | 10-40mg IV or Subcut |
| Cough | Mild to moderate | |
| Dextromethorphan | 10mg-20mg PO q 4-6 hrs PRN | |
| Hydrocodone | 5mg PO q 4-6hrs PRN | |
| Severe | ||
| morphine | 2.5 – 5 mg PO q4hrs (SC dose is ½ of oral dose). | |
| If already on opioid, titrate dose. | ||
| hydromorphone | 0.5 – 1 mg PO Q4H (SC dose is ½ of oral dose) | |
| If already on opioid, titrate dose | ||
| Pain | Morphine (a very good first-line opioid) | See clinical guidelines |
| Hydromorphone | See clinical guidelines | |
| Nausea vomiting | Metoclopramide | 5mg -10mg subcut q4hrs PRN (PO if not severe) |
| Ondansetron | 4mg – 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 …)