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Glycopyrronium CSCI Starting Dose — SCE Palliative Medicine MCQ

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EasySyringe Driver & Drug CompatibilityGlycopyrronium CSCI Starting DoseSCE Palliative Medicine

A patient’s continuous subcutaneous infusion (CSCI), containing morphine 30 mg and haloperidol 5 mg per 24 hours, requires an antisecretory agent for excess respiratory secretions. Glycopyrronium is selected. At what dose should glycopyrronium be started in the syringe driver for secretion management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — 0.6–1.2 mg/24 hours via CSCI, starting at 600 micrograms and increasing to 1200 micrograms if required

National NHS England palliative care prescribing guidance specifies starting glycopyrronium via CSCI at 600 micrograms over 24 hours, increasing to 1200 micrograms if needed—making option D the single correct answer. Option A (6 mg) and B (10 mg) are dangerously excessive, risking anticholinergic toxicity. Option C (0.1 mg) is far below therapeutic threshold. Option B describes a PRN bolus dose, inappropriate once a continuous infusion is indicated.

Reference: NHS England Palliative Care Pain & Symptom Control Guidelines for Adults (2020); NHS England Guidance on symptom control using non‑oral routes (2020)