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Although effective, reports of difficulty with swallowing the 3-Drug mix, and a significant number of ‘outliers’ (those whose death took more than 4 hours) led to the development of a 4-Drug or ‘DDMP’ protocol. In this drug mixture, chloral hydrate is re- placed with the cardiac drug, digoxin. Digoxin, in conjunction with the B-Blocker propranolol, form a ‘cardiac switch’. The morphine and diazepam (Valium) mix provide sedation before death from ischaemic hypoxia (as the heart is stopped). See the ‘Physiology of Death’ Chapter for why this is important.
The required drugs are show below:
• 10gm of morphine • x100 of 10mg tablets valium (total 1gm) • x25 of 80mg tablets propranolol (total 2gm) • x8 bottles (or 800 tablets) digoxin (total 100mg)