A Survey of the Use of Bolus Subcutaneous Injection of Pantoprazole in Palliative Care
Eloise Naylor, Alpna ChauhanObjective:
To investigate the use, feasibility and tolerability of bolus subcutaneous injection of pantoprazole in the specialist palliative care hospice inpatient setting.
Method:
A retrospective review of the electronic records and paper administration charts of the first 10 patients who received a slow bolus subcutaneous injection of pantoprazole in a hospice inpatient unit.
Results:
The most common indications for a proton pump inhibitor were gastro-esophageal reflux disease and gastroprotection. Loss of swallow in the last days of life was the most common reason for the subcutaneous route. 80% of patients tolerated bolus subcutaneous pantoprazole and may have received clinical benefit. Two patients developed skin irritation at the subcutaneous injection site.
Conclusion:
Bolus subcutaneous pantoprazole is a potential alternative treatment when a proton pump inhibitor is indicated, and the oral route is not available or effective. There is a risk of skin irritation requiring careful monitoring. Controlled research is needed.