The decision to prescribe medicines ahead of time should always be based on a risk / benefit analysis.
Anticipatory prescribing for the most frequently occurring symptoms in the deteriorating and/or end-of-life phases:
- Prevents crises and unplanned admissions to hospitals; and
- Supports dying at home for those patients and their caregivers where this is their choice
Prior to prescribing, confirm and document:
- Exclusion of reversible / treatable causes, where appropriate
- Agreement from the team of the diagnosis of dying
- Discussion with the family
- Review of all current prescription.
If a patient is currently receiving subcutaneous analgesics, anxiolytics, antipsychotics or antiemetics; consider adding or increasing the doses of PRN medicines to manage emergent symptoms
All anticipatory orders should be reviewed after 24 hours
Pharmaceutical responses to common symptoms:
Prescribing considerations for all symptoms
- Continue to review regularly
- If regular doses are required, consider using a syringe driver to deliver medicines over 24 hours
- Check availability of medicines through the patient's usual pharmacy
The medicines listed throughout this app are in line with those endorsed by Caring at Home and the Australian and New Zealand Society of Palliative Medicine (ANZSPM) within the Community End-of-Life Medicines List (168kb pdf).
Page updated 19 July 2018