Syringe drivers are often required to provide medicines for symptom management in patients who are terminally ill. They provide continuous subcutaneous administration of medicines to enable effective symptom control when medicines given by other routes are inappropriate or no longer effective. With guidance and support from the local hospice or district nursing services, General Practitioners can arrange a syringe driver infusion for a patient in their home or in a residential care facility, prescribe and monitor the appropriate mix of medicines and manage breakthrough symptoms.Get more news about Advanced Syringe Auto Feeder,you can vist our website!

What is a syringe driver?
A syringe driver is a small, portable, battery operated device that administers medicines subcutaneously over a selected time period, usually 24 hours. Medicines are drawn up into a syringe that is then attached to the driver, which is set to move the plunger of the syringe forward at an accurately controlled rate. Syringe drivers can be used either short-term or long-term, for patients who are ambulatory and those who are confined to bed. Syringe drivers can be placed into a carry bag or pouch when a patient is mobile or be tucked under a pillow if the patient is bed-bound.
Indications for use of a syringe driver
Continuous subcutaneous administration of medicines using a syringe driver often becomes necessary for the control of symptoms during palliative care. A syringe driver is useful when the oral route of administration is not possible and repeated subcutaneous doses are inappropriate, ineffective or impractical. Although medicines can also be administered by other routes, such as rectal or sublingual, a further advantage of a continuous subcutaneous infusion is that any peaks and troughs of intermittent delivery methods are avoided (Table 1)
Talking about syringe drivers with patients and family/whānau
Initiating use of a syringe driver in a patient during palliative care may represent a significant and unwelcome milestone for the patient and their family/whānau, because syringe drivers are often required when a patient is close to death. The goals of administering medicines via a syringe driver therefore need to be discussed with the patient and family and any concerns addressed. A syringe driver simply provides an alternative route for the administration of medicines. For example, a patient with severe nausea and vomiting that temporarily prevents the use of oral medicines may need a syringe driver to gain control of symptoms. It may be possible to revert back to the use of oral medicines once control of the nausea and vomiting is achieved.4
Arranging a syringe driver for a patient
Hospice or district nursing services can provide equipment and certified staff who can work with General Practitioners, patients and their families/whānau. Many patients will also be under the care of a palliative care physician. It is essential that there is good communication between the people who are providing care and support for the patient and their family (this also includes community pharmacy). Many residential aged care facilities have syringe drivers on site and staff trained in their use.
Most symptoms can be controlled with a continuous subcutaneous infusion
In a palliative care setting, subcutaneous administration of medicines given via a syringe driver is useful for managing symptoms such as pain, nausea, anxiety and restlessness. Injectable forms of medicines to control symptoms can be given alone, or mixed together in a syringe depending on their physical and chemical compatibility and the diluents used (see below).

Choice of medicine and prescribing
In palliative care, medicines may be prescribed for unapproved indications, be administered by an unapproved route or given in doses not seen in routine day-to-day practice.5 Most medicines can be used in a subcutaneous infusion, however, chlorpromazine, prochlorperazine and diazepam are contraindicated as they can cause skin reactions at the injection site.

Infusions for administration via continuous subcutaneous infusion using a syringe driver should be prescribed to run over 24 hours, although medicines mixed together may be pharmaceutically compatible and stable for longer than this.

MIT researchers have developed a simple, low-cost technology to administer powerful drug formulations that are too viscous to be injected using conventional medical syringes.Get more news about Advanced Syringe Auto Feeder,you can vist our website!

The technology, which is described in a paper published today in the journal Advanced Healthcare Materials, makes it possible to inject high-concentration drugs and other therapies subcutaneously. It was developed as a solution for highly effective, and extremely concentrated, biopharmaceuticals, or biologics, which typically are diluted and injected intravenously.

"Where drug delivery and biologics are going, injectability is becoming a big bottleneck, preventing formulations that could treat diseases more easily," says Kripa Varanasi, MIT professor of mechanical engineering. "Drug makers need to focus on what they do best, and formulate drugs, not be stuck by this problem of injectability."

Leaders at the Bill and Melinda Gates Foundation brought the injectability problem to Varanasi after reading about his previous work on dispensing liquids, which has attracted the attention of industries ranging from aviation to makers of toothpaste. A main concern of the foundation, Varanasi says, was with providing high-concentration vaccines and biologic therapies to people in developing countries who could not travel from remote areas to a medical setting.

In the current pandemic, Varanasi adds, being able to stay home and subcutaneously self-administer medication to treat diseases such as cancer or auto-immune disorders is also important in developed countries such as the United States.Varanasi and Vishnu Jayaprakash, a graduate student in MIT's mechanical engineering department who is the first author on the paper, designed a system that would make subcutaneous injection of high-concentration drug formulations possible by reducing the required injection force, which exceeded what is possible with manual subcutaneous injection with a conventional syringe.

In their system, the viscous fluid to be injected is surrounded with a lubricating fluid, easing the fluid's flow through the needle. With the lubricant, just one-seventh of the injection force was needed for the highest viscosity tested, effectively allowing subcutaneous injection of any of the more than 100 drugs otherwise considered too viscous to be administered in that way.

"We can enable injectability of these biologics," Jayaprakash says. "Regardless of how viscous your drug is, you can inject it, and this is what made this approach very attractive to us."

Biologic drugs include protein-based formulations and are harvested from living cells. They are used to treat a wide range of diseases and disorders, and can bind with specific tissues or immune cells as desired, provoking fewer unwanted reactions and bringing about particular immune responses that don't occur with other drugs.

"You can tailor very specific proteins or molecules that bind to very specific receptors in the body," says Jayaprakash. "They enable a degree of personalization, specificity, and immune response that just isn't available with small-molecule drugs. That's why, globally, people are pushing toward biologic drugs."