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Just in Case 4 Core Drugs (JiC4CDs) for Anticipatory Prescribing
Prescribing Advice
‘JUST IN CASE 4 CORE DRUGS’ FOR ANTICIPATORY
PRESCRIBING
The patient is prescribed an e-discharge prescription as usual.
The prescriber must also write a paper TTO for all four of the JiC4CDs,
including Water for Injections
The doses and quantities that should be prescribed are shown
opposite. Different doses may be necessary if clinically indicated, but
only 5 days’ supply should be prescribed.
Diamorphine and midazolam are controlled drugs. Ensure the
strength & quantity of ampoules is written in both words and figures
e.g. Midazolam 10mg/2mL amps
Dose: 2.5-5mg PRN 4hrly
Please supply TEN (10) amps
Print name, sign and date TTO where requested.
Include bleep number in case Pharmacy need to make contact.
Complete the relevant sections of the JiC4CD MAR
(available from the Hospital Discharge Team)
If any drugs other than the following are used for anticipatory prescribing,
the JiC4CD Policy will not apply.
This table describes recommended starting doses and frequencies for the
JIC4CDs. Different doses may be necessary if clinically indicated.
Diamorphine (for pain)
Stat if naïve: 2.5-5mg PRN 1hourly subcutaneously
If the patient is already taking an opioid,
appropriate PRN doses of diamorphine should be
prescribed.*
Supply
10 x 10mg amps
5 days’ supply
Levomepromazine (for nausea & vomiting)
Stat dose: 6.25mg PRN 8hourly subcutaneously
Supply
5 x 25mg/mL amps
Midazolam (for restlessness & terminal agitation)
Stat dose: 2.5-5mg PRN 4hourly subcutaneously
Supply
10 x 10mg/2mL amps
Glycopyrronium (for respiratory tract secretions)
Stat dose: 0.2mg PRN 4 hourly subcutaneously
Supply
10 x 200mcg/1mL amps
Water for Injections
Diluent
*
Supply
10 x 10mL amps
If the patient was taking oral oxycodone, subcutaneous oxycodone should be used.
In such cases, the JiC4CD policy will not apply.