The Pharmaceutical Journal
Vol 269 No 7217 p461
28 September 2002

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Help for all pharmacists in palliative care

‘The syringe driver’, by Andrew Dickman, Clare Littlewood and James Vagra. Pp xi+157. Price £19.95. Oxford: Oxford University Press; 2002. ISBN 0 19851550 2

This book brings together information on the operation of the syringe driver, drug monographs, symptom control and stability data, providing a resource for both specialists in palliative care and those giving care in a generalist setting.

The referenced drug monographs cover a wide range of drugs used both in the United Kingdom and internationally. This is particularly useful because dose information for this unlicensed route is difficult to find.

Management of common symptoms requiring continuous subcutaneous infusion is covered. This section is not referenced but provides useful treatment plans for the management of pain, nausea and vomiting, restlessness and agitation, and respiratory tract secretions.

The final section gives compatibility data for combinations of up to five drugs in a single infusion. The information here comes both from validated stability studies and from the clinical observations of the authors. Caution is required when using the clinical data since it may not apply in all circumstances and regular in-use checking of any unfamiliar combination is recommended. Good evidence is difficult to obtain for these combinations, so the sharing of clinical experience is helpful.

This pocket-sized book provides a handy reference both for pharmacists involved in generalist palliative care in the acute or primary care setting and for those involved in specialist palliative care teams or hospices.

Fiona Montgomery