Articoli Open access

Utilizzo di farmaci per via sottocutanea nel paziente terminale. Una breve revisione

Autori

Pubblicato
18 luglio 2020
Sezione
Articoli
DOI
10.4081/scenario.2020.431
Pagine
37-42

Abstract

La somministrazione di farmaci per via sottocutanea è una pratica molto comune nelle cure palliative per il controllo dei sintomi nel fine vita. La letteratura offre studi per lo più di tipo osservazionale dai quali emerge un ampio spettro di farmaci somministrabili per via sottocutanea nei pazienti terminali. Nella pratica clinica si somministrano per via sottocutanea molti farmaci con beneficio nel trattamento dei sintomi del fine vita ma le evidenze scientifiche sono scarse; le raccomandazioni derivano soprattutto da case report e valutazioni derivate dall’opinione degli esperti.

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Riferimenti bibliografici

  1. International Association for Hospice Palliative Care. Global Consensus-based palliative care definition.. Houston, TX: The International Association for Hospice and Palliative Care; 2018 [online]. Available from: https://hospicecare.com/what-we-do/projects/consensus-based-definition-of-palliative-care/definition/ [ultimo accesso 10/05/2020]
  2. Justino ET, Kasper M, Santos KDS, Quaglio RC, Fortuna CM. Palliative care in primary health care: scoping review. Rev Lat Am Enfermagem. 2020;28:e3324. Published 2020 Jul 1. doi:10.1590/1518-8345.3858.3324
  3. van Marum RJ, de Vogel EM, Zylicz Z. Continue subcutane infusie in de palliatieve zorg, een ondergewaardeerde methode [Continuous subcutaneous infusion in palliative care, an undervalued method]. Ned Tijdschr Geneeskd. 2002;146(47):2221-2224.
  4. van Heest FB, Meyboom-de Jong B, Otter R. Consultatieve palliatieve zorg bij misselijkheid en braken in de thuissituatie [Consultative palliative care for nausea and vomiting in the home setting] [published correction appears in Ned Tijdschr Geneeskd. 2003 Dec 27;147(52):2612] [published correction appears in Ned Tijdschr Geneeskd. 2003 Oct 4;147(40):1992]. Ned Tijdschr Geneeskd. 2003;147(27):1297-1300.
  5. Masman AD, van Dijk M, Tibboel D, Baar FP, Mathôt RA. Medication use during end-of-life care in a palliative care centre. Int J Clin Pharm. 2015;37(5):767-775. doi:10.1007/s11096-015-0094-3
  6. Justad M. Continuous subcutaneous infusion: an efficacious, cost-effective analgesia alternative at the end of life. Home Healthc Nurse. 2009;27(3):140-149. doi:10.1097/01.NHH.0000347677.15617.ff
  7. Herndon CM, Fike DS. Continuous subcutaneous infusion practices of United States hospices. J Pain Symptom Manage. 2001;22(6):1027-1034. doi:10.1016/s0885-3924(01)00365-7
  8. Guidelines for the Use of Subcutaneous Medication in Palliative Care. NHS Lanarkshire. Dec 2009, Review Dec 2011.
  9. Anderson SL, Shreve ST. Continuous subcutaneous infusion of opiates at end-of-life. Ann Pharmacother. 2004;38(6):1015-1023. doi:10.1345/aph.1D395
  10. Bartz L, Klein C, Seifert A, Herget I, Ostgathe C, Stiel S. Subcutaneous administration of drugs in palliative care: results of a systematic observational study. J Pain Symptom Manage. 2014;48(4):540-547. doi:10.1016/j.jpainsymman.2013.10.018
  11. Bottomley DM, Hanks GW. Subcutaneous midazolam infusion in palliative care. J Pain Symptom Manage. 1990;5(4):259-261. doi:10.1016/0885-3924(90)90020-k
  12. Wells GH, Mason LD, Foreman E, Chambers J. Continuous subcutaneous levetiracetam in the management of seizures at the end of life: a case report. Age Ageing. 2016;45(2):321-322. doi:10.1093/ageing/afv195
  13. Furtado I, Gonçalves F, Gonçalves J, Neves J. Continuous subcutaneous levetiracetam in end-of-life care. BMJ Case Rep. 2018;2018:bcr2017222340. Published 2018 Jan 18. doi:10.1136/bcr-2017-222340
  14. Stirling LC, Kurowska A, Tookman A. The use of phenobarbitone in the management of agitation and seizures at the end of life. J Pain Symptom Manage. 1999;17(5):363-368. doi:10.1016/s0885-3924(99)00006-8
  15. Hosgood JR, Kimbrel JM, McCrate Protus B, Grauer PA. Evaluation of Subcutaneous Phenobarbital Administration in Hospice Patients. Am J Hosp Palliat Care. 2016;33(3):209-213. doi:10.1177/1049909114555157
  16. Nakayama H, Echizen H, Ogawa R, Akabane A, Kato T, Orii T. Induration at Injection or Infusion Site May Reduce Bioavailability of Parenteral Phenobarbital Administration. Ther Drug Monit. 2017;39(3):297-302. doi:10.1097/FTD.0000000000000391
  17. Armstrong P, Wilkinson P, McCorry NK. Use of parecoxib by continuous subcutaneous infusion for cancer pain in a hospice population. BMJ Support Palliat Care. 2018;8(1):25-29. doi:10.1136/bmjspcare-2017-001348
  18. Agenzia Italiana del Farmaco. Banca dati farmaci Agenzia Italiana del Farmaco. Banca dati farmaci. Disponibile: https://farmaci.agenziafarmaco.gov.it/bancadatifarmaci/ (ultimo accesso 16/10/2019)
  19. Pérez LM, Farriols C, Puente V, Planas J, Ruiz I. The use of subcutaneous scopolamine as a palliative treatment in Parkinson's disease. Palliat Med. 2011;25(1):92-93. doi:10.1177/0269216310381662
  20. Negro S, Reyes R, Azuara ML, Sánchez Y, Barcia E. Morphine, haloperidol and hyoscine N-butyl bromide combined in s.c. infusion solutions: compatibility and stability. Evaluation in terminal oncology patients. Int J Pharm. 2006 Jan 13;307(2):278-84
  21. Negro S, Martín A, Azuara L, Sánchez Y, Barcia E. Compatibility and stability of tramadol and dexamethasone in solution and its use in terminally ill patients. J Palliat Med. 2010 Mar;13(3):273-7.
  22. Dickman A, Bickerstaff M, Jackson R, Schneider J, Mason S, Ellershaw J. Identification of drug combinations administered by continuous subcutaneous infusion that require analysis for compatibility and stability. BMC Palliat Care. 2017;16(1):22. Published 2017 Mar 23. doi:10.1186/s12904-017-0195-y
  23. Baker J, Dickman A, Mason S, Ellershaw J. The current evidence base for the feasibility of 48-hour continuous subcutaneous infusions (CSCIs): A systematically-structured review. PLoS One. 2018;13(3):e0194236. Published 2018 Mar 14. doi:10.1371/journal.pone.0194236
  24. Thomas T, Barclay S. Continuous subcutaneous infusion in palliative care: a review of current practice. Int J Palliat Nurs. 2015;21(2):60-64. doi:10.12968/ijpn.2015.21.2.60
  25. Flowers C, McLeod F. Diluent choice for subcutaneous infusion: a survey of the literature and Australian practice. Int J Palliat Nurs. 2005;11(2):54-60. doi:10.12968/ijpn.2005.11.2.17670
  26. McLeod F, Flowers C. A practical guide for nurses in diluent selection for subcutaneous infusion using a syringe driver [published correction appears in Int J Palliat Nurs. 2007 Feb;13(2):55]. Int J Palliat Nurs. 2006;12(12):558-565.

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