Selected items from the News and Latest Additions sections of www.palliativedrugs.com, the world’s leading palliative care website.
Safety alerts
Patient Safety Alert for Fluid/Food Thickening Powder
NHS England has issued a patient safety alert (NHS/PSA/W/2015/002) warning of the risk of death from asphyxiation by accidental ingestion of fluid/food dry thickening powder. For more information, click here.
Hot topics
New Drug Driving Legislation Now in Force
The new offence of driving or attempting to drive with certain controlled drugs above specified limits in the blood came into force on 2nd March 2015, in England and Wales. The legislation covers eight illegal drugs and eight prescription drugs including:
- benzodiazepines; clonazepam, diazepam, lorazepam, oxazepam, temazepam
- opioids; diamorphine, methadone, morphine
- psychostimulants; amphetamine
- others; cannabis-based medicines (e.g. Δ9-tetrahydrocannabinol), ketamine.
The main focus of the new law is the illicit use of these drugs. Accordingly, provided driving is not impaired and the drugs are being taken as directed either by a health professional or the Patient Information leaflet (PIL), drivers lawfully using these drugs are exempt from prosecution (the ‘medical defence’). Thus, it is important to inform patients of this if prescribed these drugs and they intend to drive. The MHRA and Department for Transport have produced information for patients (see below). PCF Chapter 19 on drugs and fitness to drive will be updated shortly.
MHRA: Information for patients
Department for transport: Guidance for health professionals
Department for transport: Information for patients
Department for transport: Drugs and driving
Choice in End of Life Care Report
An independent report ‘Review of Choice in End of Life Care’, which provides advice to the Government has been published. For more information, click here.
Drug Updates
Ketamine Supply Update
There have been ongoing manufacturer supply problems with all strengths of ketamine injection (Ketalar; Pfizer) since November 2012 in the UK. Some units have been using imported products of varying strengths, presentation and type (see our news item 6th June 2014). We can report that ketamine injection 50mg/mL (10mL vial) is now available via Pfizer. It is manufactured by Pfizer in Turkey, but is identical in content to the UK product and approved by the UK MHRA. It is presented in an amber vial with a yellow flip cap and red stopper (UK product was a clear vial and a grey cap and stopper). Pfizer anticipate that the 10mg/mL (20mL vials) and 100mg/mL (10mL vials) will be available March 2015. For further details contact Pfizer customer services (01304 616161).
Latest Additions
PCF Updated Monographs
The following monographs of the on-line Palliative Care Formulary (PCF) have been updated during February 2015 and supersede those in the publication of the 5th edition of the Palliative epdf. They can be accessed from the formulary section of the website:
Chapter 04: Antihistaminic antimuscarinic anti-emetics (minor change)
Chapter 04: Quick Clinical guide: Vertigo (new)
Chapter 06: Urinary tract infections (minor change).
In addition, a correction has been made to the following monograph: Chapter 29: Oral nutritional supplements (correction November 2014).
For further details of the minor changes or corrections, see the individual notifications in the Latest additions section of the website.
For a full list of all the monographs updated since the publication of PCF5, click here. Follow us on twitter @palliativedrugs for the latest updates.
Save 33%: Strong Opioids and the Relief of Cancer Pain Booklet
The booklet Strong opioids and the relief of cancer pain; Information for patients, families and friends (produced by the editorial team of the Palliative Care Formulary) has been reduced to £3.99 (from £5.99) while stocks last. The question and answer style booklet, which carries the prestigious Crystal Mark for clarity, was published in December 2013 (see our news item 17th December 2013).
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 now priced £3.99 (discounts available for purchases of 10 or more) or from amazon. For more information, click here.
Prepared by Sarah Charlesworth and Andrew Wilcock