Selected items from the News and Latest Additions sections of www.palliativedrugs.com, the world’s leading palliative care website.
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Consultation on end of life care guidance
The Leadership Alliance for the Care of Dying People (LACDP), set up in response to the recommendations from the independent report into the Liverpool Care Pathway (see news item 30-08-2013), has published a consultation document about care in the last days of life. The document can be downloaded from the NHS England website and feedback can be given via the on-line survey on the website until 6 January 2014.
MHRA guidance on switching between different manufacturer’s products of anti-epileptic drugs
The UK Medicines and Healthcare products Regulatory Agency (MHRA) has issued guidance on switching between different manufacturer’s products of anti-epileptic drugs. The anti-epileptics are split into the 3 groups below to help prescribers decide whether it is necessary to maintain continuity of supply of a specific manufacturer’s product. This advice relates to the treatment of epilepsy and is not intended for other indications e.g. mood stabilisation, neuropathic pain. For more information, click here.
Group 1: Carbamazepine, phenobarbital, phenytoin, primidone.
Ensure the patient is maintained on a specific manufacturer’s product. Prescribe either by specifying a brand name or by using the generic drug name and name of the manufacturer (marketing authorization holder).
Group 2: Clobazam, clonazepam, eslicarbazepine, lamotrigine, oxcarbazepine, perampanel, retigabine, rufinamide, topiramate valproate, zonisamide.
Base the need for continuity of supply of a specific manufacturer’s product on clinical judgement, patient consultation, seizure frequency and treatment history.
Group 3: Ethosuximide, gabapentin, lacosamide, levetiracetam, pregabalin, tiagabine, vigabatrin.
Usually unnecessary to maintain a patient on a specific manufacturer’s product unless there are specific concerns such as patient anxiety, confusion or risk of dosing errors.
Neuropathic pain guidelines published
The UK National Institute for Health and Care Excellence (NICE) has published its guidelines on the pharmacological management of neuropathic pain in adults in a non-specialist setting (CG173). This supersedes the previous guideline 96.