Selected items from the News and Latest Additions sections of www.palliativedrugs.com, the world’s leading palliative care website with over 30,000 members from 169 Countries.
SAFETY UPDATES
CME T34 syringe pumps now require foam pads to be added to the battery compartment
All Caesarea Medical Electronics (CME) T34 Ambulatory syringe pumps in the UK now need a foam pad to be added to the battery compartment to ensure the battery rests securely against the contacts. Kits should be ordered from CME to do this.
This information is in the latest CME field safety notice (FSN2018-001_Updated) and follows the previous alerts in March and September 2018, highlighting the possible loss of function due to inadequate battery connection. For more information, click here.
Risk of severe and fatal burns with emollients
Warnings about the risk of severe and fatal burns are being extended to all paraffin-based emollients regardless of the paraffin concentration. The Medicines and Healthcare products Regulatory Agency (MHRA) state that the emollients themselves are not flammable, however they act as an accelerant when there is a build-up of emollient on fabric, e.g. clothing, bedding or dressings. Patients should be instructed not to smoke or go near naked flames. For more information, click here.
MHRA new restrictions and precautions for fluoroquinolone antibiotics
New restrictions and precautions for use of fluoroquinolone antibiotics (ciprofloxacin, levofloxacin, moxifloxacin and ofloxacin) are being introduced by the MHRA following very rare reports of potentially irreversible undesirable effects affecting the musculoskeletal and nervous systems, e.g. tendinitis, muscle pain, joint pain, peripheral neuropathy. Information for health professionals includes:
- to advise patients to stop treatment at the first signs of a serious undesirable effect and to contact their doctor immediately for further advice
- not to prescribe fluoroquinolones:
-
- for non-severe or self-limiting infections, or non-bacterial conditions
- for some mild–moderate infections unless other antibiotics that are commonly recommended are considered inappropriate (see updated SPC indications)
- to prescribe with special caution for people at a higher risk of tendon injury, e.g. >60 years, those with renal impairment or solid-organ transplants
- to avoid use of a corticosteroid with a fluoroquinolone as this may increase the risk of tendinitis and tendon rupture
- to report suspected undesirable effects via the MHRA yellow card scheme.
Full details are available in the MHRA March 2019 Drug Safety Update. An advice sheet for patients has also been produced. For more information, click here.
HOT TOPICS
Cochrane review: Pregabalin for neuropathic pain
An update on the use of pregabalin for neuropathic pain in adults, has found no substantial change from the 2009 findings. There is evidence of efficacy in postherpetic neuralgia, painful diabetic neuropathy, and mixed or unclassified post-traumatic neuropathic pain; there a lack of efficacy in HIV neuropathy and inadequate evidence of efficacy in central neuropathic pain. Some people will derive substantial benefit with pregabalin; more will have moderate benefit, but many will have no benefit or will discontinue treatment. For more information, click here.
Pharmacies now able to dispense controlled drugs via the Electronic Prescription Service
NHS Digital is rolling out prescribing Schedule 2 and 3 controlled drugs, except oral liquid methadone, via the Electronic Prescription Service, following a successful trial in GP practices. For more information, click here.
Gosport report: Pharmacy bodies publish a reflection and learning resource
The General Pharmaceutical Council, Royal Pharmaceutical Society and Association of Pharmacy Technicians in the UK have joined together to publish a reflection and learning resource to support pharmacy to learn the lessons from the Gosport Independent Panel report, which was published in June 2018. In addition, the Royal Pharmaceutical Society’s Hospital Expert Advisory Group has published a discussion paper on areas requiring action.
DRUG UPDATES
Glycopyrronium 1mg/5mL oral solution updated indications
Glycopyrronium bromide 1mg/5mLoral solution (Colonis Pharma) is now authorized in the UK for the treatment of severe in children and adolescents ≥ 3 years with chronic neurological disorders. Previously, only the Sialanar® product (Glycopyrronium bromide 2mg/5mL) was authorized for this indication. For the SPC, click here.
LATEST ADDITIONS
Strong opioid TD patch monitoring chart
palliativedrugs.com strong opioid transdermal (TD) patch monitoring chart has been updated and added to the Document library under the topic of Pain (strong opioids). This 2019 version supersedes the previous version from 2017 which has now been removed. Click here.
Prevention of SRE survey?
Results are available from our survey, on the prevention of skeletal-related events in adults with bone metastases from solid tumours, on the Latest additions section of the www.palliativedrugs.com website. Click here.
PCF updated monographs
The on-line PCF is being continually updated. Some of the website monographs now supersede those in the print publication of the 6th edition of the Palliative Care Formulary (PCF6). During January to March 2019 the following monographs have been updated and can be accessed on the MedicinesComplete website:
Chapter 01: Loperamide (minor update), Pancreatin
Chapter 04: Antidepressants (minor update), Mirtazapine (minor update), Olanzapine (minor update), Levetiracetam (minor update)
Chapter 08: Catheter patency solutions
Chapter 09: Zinc
Chapter 20: QT prolongation
A full list of all the monographs updated since the publication of PCF6 can be found on the Latest additions section of the www.palliativedrugs.com website, along with more details of the minor updates. In addition, follow @palliativedrugs on twitter for the latest updates.
Prepared by Sarah Charlesworth and Andrew Wilcock