Selected items from the News and Latest Additions sections of www.palliativedrugs.com, the world’s leading palliative care website.
Safety updates
Class 4 drug alert: Matrifen 100microgram/h TD patches
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 25th 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. For more information, click here.
NG tube placement checks reminder
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. For more information, click here.
Hot topics
Pain e-learning package
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 30min 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. For more information, click here.
Cochrane overview of anti-epileptic drugs for neuropathic pain and fibromyalgia
An overview of Cochrane reviews on anti-epileptic drugs for neuropathic pain and fibromyalgia (CD010567.pub2) has been published.
SIGN guideline management of chronic pain
The Scottish Intercollegiate Guidelines network (SIGN) has published its guideline on the management of chronic pain (SIGN 136).
NICE to distribute BNF annually
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.
Prepared by Sarah Charlesworth and Andrew Wilcock