A Survey of the Use of Bolus Subcutaneous Injection of Pantoprazole in Palliative Care

OBJECTIVE: 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.