Follow @palliativedrugs on twitter

30th December 2013

www.palliativedrugs.com is now on twitter! Follow us @palliativedrugs or via the twitter icon on our home page for news on drugs in palliative care and updates to the on-line Palliative Care Formulary and website. Please retweet us!

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NICE to distribute BNF annually

27th December 2013

The British National Formulary (BNF) is produced in print twice a year in March and September. However, the UK National Institute for Health and Care Excellence (NICE) is to change to distributing the print version once a year in September (still free of charge to eligible prescribers), in addition to the availability via its website and app. NICE will not be purchasing the March 2014 edition for nationwide distribution to NHS health professionals in England. Copies can be purchased through the Pharmaceutical press website.

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Class 4 drug alert: Matrifen 100microgram/h TD patches

17th December 2013

The UK Medicines and Healthcare products Regulatory Agency (MHRA) have issued a Class 4 drug alert (caution in use) for the Matrifen brand of fentanyl 100microgram/h transdermal patches (Takeda UK, Teva livery 01628 537900 ).

There is an error in the text on the pouch for batches of patches distributed since 25 May 2013. The strength is expressed correctly in the heading but in the smaller body text underneath, it is expressed incorrectly, as 75microgram/h. The size of the patch is also stated incorrectly. It is given as 25.2cm², whereas it is actually 33.6cm². The text on the carton, the patch label and in the patient information leaflet is all correct.

To avoid disruption of supply, distribution of affected stock will continue for the next few weeks. Corrected stock is expected to be available during February 2014, when distribution of affected stock will cease.

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Strong opioids and the relief of cancer pain: Information for patients, families and friends

17th December 2013

We are proud to announce the publication of a new booklet Strong opioids and the relief of cancer pain: Information for patients, families and friends published by the editorial team of the Palliative Care Formulary. Based on the booklet Oral Morphine and the Relief of Cancer Pain: Information for patients, families and friends by Dr Robert Twycross and Dr Sylvia Lack (Beaconsfield publishers 1987), it has been fully revised to include all strong opioids. 

Written in question and answer form, Strong Opioids and the Relief of Cancer Pain deals with the many concerns which patients, and their family and friends, may have when a strong opioid is first prescribed. It is not meant to be read straight through from beginning to end; it is more for dipping into. Easy to understand language is used throughout which has been approved by the Plain English Campaign and carries the prestigious Crystal Mark for clarity. Some example questions answered include:

• Will I become addicted?
• How soon will I become pain-free?
• What should I do if I forget to take a dose?
• What can I do if the pain comes back between regular doses?
• What about unwanted effects with skin patches?
• Do strong opioids have many unwanted effects?
• What is 'spinal' morphine? 

It is available via our store priced £5.99 including p&p, (discounts available for purchases of 10 or more) or from amazon.

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Cochrane overview of antiepileptic drugs for neuropathic pain and fibromyalgia

12th December 2013

An overview of Cochrane reviews on antiepileptic drugs for neuropathic pain and fibromyalgia (CD010567.pub2) has been published.

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NG tube placement checks reminder

12th December 2013

An alert has been issued by NHS England reminding health professionals that NPSA advice on initial checks to confirm correct nasogastric (NG) tube placement i.e. pH or x-ray testing after initial insertion, should be followed for all NG tubes including those with placement devices. This follows 2 fatal incidents where enteral nutrition was unintentionally given into the respiratory tract through a misplaced NG tube inserted with the aid of a placement device.

The NPSA Alert Reducing the harm caused by misplaced nasogastric tubes in adults, children and infants (2011) stated that a pH of 1 to 5.5 or an x-ray are the only acceptable methods for confirming initial placement of a nasogastric tube. This Alert and a later Rapid Response Report (2012) also emphasised the importance of ensuring all possible steps are taken to reduce the likelihood of human error, including competency-based training for staff interpreting x-rays or testing the pH of aspirate, using CE marked pH paper intended for gastric secretions, and never inserting any substance down the tube (including lubricant to aid guide wire removal) prior to confirming initial placement. This advice still stands, even when placement devices are used.

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SIGN guideline management of chronic pain

12th December 2013

The Scottish Intercollegiate Guidelines network (SIGN) has published its guideline on the management of chronic pain (SIGN 136).

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Pain e-learning package

5th December 2013

A new multidisciplinary e-learning package designed to improve the early diagnosis and management of pain has been launched by the Faculty of Pain Medicine of the Royal College of Anaesthetists and the British Pain Society. The first two 30minute modules on Basic Pain Management and Basic Science are now available. A further 7 will be released in 2014, several of these have been written by specialist pharmacists in pain and palliative care.

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