News and updates from

Selected items from the News and Latest Additions sections of, the world’s leading palliative care website with over 30,000 members from 169 Countries.

Safety issues

Nasogastric tube misplacement: continuing risk of death and severe harm

A stage two (resource) patient safety alert (NHS/PSA/RE/2016/006) has been issued to help support implementation of the previous alerts on this issue (see our news item December 2013). This follows 95 incidents reported between September 2011 and March 2016, where fluids or medication were introduced into the respiratory tract or pleura, despite several patient safety alerts. A review highlighted problems with the organisational processes for implementing previous alerts. Thus this resource alert is directed at Trust boards (or equivalent) and the processes that support clinical governance. For more information, click here.

Citalopram suspected drug interaction with cocaine

MHRA has reminded prescribers to consider illicit drug use and the risk of drug interactions when prescribing. This follows a suspected fatal drug interaction between citalopram and cocaine. For more information, click here.

Thalidomide new risks

A letter has been sent to UK healthcare professionals about the risks of viral reactivation and pulmonary hypertension associated with thalidomide. For more information, click here.

Hot topics

NICE end of life care for infants, children and young people

NICE has published draft guidance for consultation on end of life care for infants, children and young people. The deadline for consultation responses is 12 August 2016. For more information, click here.

Cochrane review: oral morphine for cancer pain

The third updated version of this Cochrane review (CD003868) has been published. No new studies have been identified for inclusion in this update and the conclusions remain unchanged, i.e. oral morphine in either immediate-release or modified-release form remains the analgesic of choice for moderate or severe cancer pain. For more information, click here.

Cochrane review: hydromorphone for neuropathic pain

The previous Cochrane review on hydromorphone for acute and chronic pain has been updated and divided into more specific sub-sets. The authors have concluded that there is insufficient evidence to support or refute the suggestion that hydromorphone has any efficacy in any neuropathic pain condition (CD011604). For more information, click here.

Recognition of sepsis: NICE guideline published

NICE have published guidance (NG51) for the recognition, diagnosis and early management of sepsis in all areas. For more information, click here.

Choice in end of life care: government response

UK Department of Health has published a response to the independent review on choice in end of life care (February 2015). The government has made 6 commitments to the public to end variation in end of life care across the health system by 2020:

  • honest discussions between health professionals and dying people
  • dying people making informed choices about their care
  • personalised care plans for all
  • the discussion of personalised care plans with health professionals
  • the involvement of family and carers in dying people’s care
  • a main contact so dying people and their families know who to contact at any time.

For more information, click here.

CQC annual report: safer management of controlled drugs

The UK Care Quality Commission (CQC) has published their 2015 annual report on the safer management of controlled drugs. They make recommendations for controlled drugs accountable officers (CDAOs) and local authority public health and adult social care directors with regards to information collection and sharing in controlled drug local intelligence networks (CD LINs). For more information, click here.

Management of chronic pain in adult cancer survivors

The American society of clinical oncology has published guidelines on the management of chronic pain in survivors of adult cancer. For more information, click here.

RPS guide for pharmacists working in care homes

The UK Royal Pharmaceutical Society has developed guidance for pharmacists working in care homes. For more information, click here.

Drug updates

FDA authorizes dronabinol oral solution

A dronabinol oral solution (Syndros; Insys Therapeutics) has been authorized in the US for treating anorexia associated with weight loss in patients with AIDS, and nausea and vomiting associated with cancer chemotherapy in patients who have failed to respond adequately to conventional anti-emetic treatments. It is currently awaiting scheduling by the US Drug Enforcement Administration. For more information, click here.

Glycopyrronium oral solution authorized for severe drooling in the UK

European Medicines Agency has authorized a glycopyrronium 320microgram/mL oral solution (Sialanar; Proveca) for the treatment of severe drooling in children >3 years and adolescents, with neurological conditions. The Committee for medicinal products for human use had previously issued a negative opinion for wider use in patients with mild‒moderate drooling, however following re-application, authorization has been granted for severe drooling. For more information, click here.

Latest additions

PCF updated monographs summary (July 2016)

The on-line Palliative Care Formulary is being continually updated. The following monographs have been updated during July and supersede those in the print publication of the 5th edition of the Palliative Care Formulary (PCF5) and PCF5+ 2015 PDF. They can be accessed from the formulary section of the website.

Chapter 01: PPI (minor change)

For a full list of all the monographs updated since the print publication of PCF5, click here. Follow us on twitter @palliativedrugs for the latest updates.

Prepared by Sarah Charlesworth and Andrew Wilcock

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