Resource Medical Aid in Dying - DDMP and DDMA

[007Bob]

Questions to the knowledgeable:
- MAiD Protocol asks for 100mg Digitalis powder. Only Digoxin pills can be obtained. To make it equivalent to 100mg Digitalis powder, over 300 pills need to be crushed into powder. It's a lot of powder (almost half of cup). Is this going to be a big problem with regurgitation and vomiting (note that antiemetic drugs will be taken 1 h prior to ending-of-life cocktail)
- MAiD Protocol asks for instant Morphine. Only slow capsules can be obtained. Can you put SR Morphine capsules in a blender to turn it into powder?
- What do you think of a modified DDMA with 2g of Propranolol and 6g of Amitriptyline? Would it still work? What do you think are the pros and cons of this formula?
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MAiD (Medical Aid in Dying)
Safest way to die (least pain and fast)

Anti-nausea drugs (1 hour prior to end-of-life cocktail)
- Haloperidol 2mg
- Metoclopramide 20mg

END-OF-LIFE COCKTAILS

DDMP: Digoxin 50 mg, Diazepam 1 gm, Morphine 15 gm, Propranolol 2 gm.
Time to death: 2h (average) to 39h (max)
D-DMP2: As above, but digoxin is given separately, 30 minutes before the other medications.
Time to death: 1.5h to 13h
DDMA: Digoxin 100 mg, Diazepam 1 gm, Morphine 15 gm, Amitriptyline 8 gm.
Time to death: 1.5h to 12.5h
D-DMA: As above, but digoxin is given separately, 30 minutes before the other medications.
Time to death: 1.5h to 4h
DDMAPh: Digoxin 100 mg, Diazepam 1 gm, Morphine 15 gm, Amitriptyline 8gm, Phenobarbital 5 gm.
Time to death: 1.1h to 5.1h
D-DMAPh: As above, but digoxin is given separately, 30 minutes before the other medications.
Time to death: 1.1h to 3.8h

DDMP2 vs D-DMP2: NOTE: The dash in D-DMP2 signifies a pause of 30 minutes between giving
the digitalis and the morphine/diazepam/propranolol. The reason is that without giving digitalis separately, the tiny amount of digitalis
(100 milligrams) gets lost amid the huge mass of the other meds (18,000 milligrams)—and the digitalis doesn't get absorbed. By using pre-digitalis, i.e. dig alone for
30 minutes, the dig is rapidly absorbed—providing more rapid and thorough digitalis toxicity.

Additional ressources:
- https://www.acamaid.org/wp-content/...on-Protocols-for-Medical-Aid-in-Dying-1-1.pdf
- https://www.acamaid.org/wp-content/uploads/2021/12/12-5-19-DDMA-instead-of-DDMP2.pdf
- https://endoflifewa.org/wp-content/...r-Taking-Life-Ending-Medications-Jan-2020.pdf

 

[Myrmecia]

This Protocols have general the problem with a very large number of pills.
I think all the tests were only done with powder of Digoxin, Diazepam, Morphine ......

The fastest Methods are D-DMAPh or DDMAPh.
The biggest problem is to crush all this tablets and then to dissolve in water.
I don´t know how fast dissolve this in water.

What is SR Morphin?
I have 200mg Morphin tablets found in the DN.
They blue and very hard to crush.

I think 80 mg Oxycodon tablets would be a good alternate to morphin.

 

[Rubypie41]

This Protocols have general the problem with a very large number of pills.
I think all the tests were only done with powder of Digoxin, Diazepam, Morphine ......

The biggest problem is to crush all this pills and then to dissolve in water.
I don´t know how fast dissolve this pills in water.

What is SR Morphin?
I have 200mg Morphin Tablets found in the DN.
They blue and very hard to crush.

SR = Sustained release or slow release

 

[Myrmecia]

But when crushing the tablets to powder the sustaine release is faster.