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‘Just in case’ medicines for palliative care

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What are ‘Just in Case’ medicines?

Other name: Anticipatory medicines

These are medicines which are usually given by injection and are prescribed for you. They should only be administered by a trained healthcare professional. They are given to you to be kept in your home ‘just in case’ you need them. This means you could be given a medicine to help relieve pain or other symptoms if you need it, especially during the night or at a weekend.

Your usual oral medicines (e.g. painkillers) should be tried first to see if this helps. If they do not help, you or your carer can phone your community nurse or the out of hour’s community nursing service or GP to come to the house to see you. The community nurse or GP will discuss your symptoms with you and your carer (if you have one with you). They may ask you to take an extra dose of your usual oral medicines if they think that this is what is needed.

If you are unable to swallow your oral medication, are being sick or there is an issue with drug absorption then the community nurse or GP may give you an injection from your ‘just in case’ medicines.

(If you are a resident in a nursing home, the community nurse role is usually taken on by the nursing home nurse).

What are the medicines for?

You may not need any of these medicines right now; however they have been prescribed for you because they may be required at some point in the future to help with:

  • Pain relief.
  • Sickness /nausea.
  • Breathlessness or noisy breathing.
  • Anxiety or restlessness.

The community nurse or GP who gives you any of the ‘just in case’ medicines will assess you to see if the oral medicines you have taken or the injection he or she has given you has helped. They will agree a plan with you and or your carers about what to do if your regular medicines need changing or another dose of the ‘just in case’ medicines is needed.

Sometimes, if single injections are not felt by your community healthcare professionals to be sufficient, the ‘just in case’ medicine may be given constantly as an infusion using a small battery operated pump. This can be done at you usual place of residence.

Who can or should give ‘Just in Case’ medicines?

If you have ‘just in case’ medicine, you will also have had a medicine administration chart provided for the ‘just in case’ medicines. The community nurse will use this sheet to allow him or her to check and give the correct medicine and dose to help relieve your symptoms. Having these documents in your home means you do not have to wait for a GP to come out to see you.

How do I look after my ‘Just in Case’ medicines

The medicines have been prescribed for you, and should not be given to or taken by anyone else. Keep your ‘just in case’ medicines in a safe place out of the reach of children or vulnerable adults. They do not need to be kept in a fridge.

When you receive your ‘just in case’ medicines the community nurse should check and note the expiry date of each medicine. The expiry dates should be checked each month. If your ‘just in case’ medicines expiry date is near let your GP practice or community nurse know so that a prescription can be obtained to get a new supply of your ‘just in case’ medicines.

If your condition changes, you or your carer should let your GP and or community nurse know so that they can reassess you and make sure your regular medicines and ‘just in case’ medicines and their doses are still right for you. If ‘just in case’ medicines or any other medicines are no longer required, they should be returned to your community pharmacy.

Any questions?

If you have any questions about your ‘just in case’ or regular medicines, please ask your community nurse, GP or community palliative care nurse, if you have one.

Created by Simon Matthews August 2013.   Approved by DTC: October 2013.  Adapted for local use from the NHS Lothian ‘just in case medication for palliative care (Nov 2012)’ leaflet.

The information here is for guidance purposes only and is in no way intended to replace professional clinical advice by a qualified practitioner.

This information is for patients receiving care at Brighton and Haywards Heath.

Publication Date: June 2017

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