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Anticipatory Prescribing — SCE Medical Oncology MCQ

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EasySupportive & Palliative OncologyAnticipatory PrescribingSCE Medical Oncology

A 55-year-old woman with terminal cancer is being cared for at home. She is no longer able to take oral medications. The GP is asked to write an anticipatory prescribing (just-in-case) prescription. What four drugs should be included in a standard anticipatory prescribing kit?

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Correct answer: B — Morphine, midazolam, haloperidol, hyoscine butylbromide

The standard UK anticipatory prescribing (just-in-case) kit for end-of-life care contains four subcutaneous injectable medications: (1) morphine sulfate (pain), (2) midazolam (agitation/seizures), (3) haloperidol or levomepromazole (nausea/agitation/delirium), (4) hyoscine butylbromide (respiratory secretions). These cover the four most common symptoms at end of life and are administered via SC injection or syringe driver. NICE NG31 and local palliative care guidelines standardise this approach.

Reference: NICE NG31 Care of dying adults; NICE CG140 Opioids in palliative care; Palliative Care Formulary