{"id":1324,"date":"2018-01-05T12:00:36","date_gmt":"2018-01-05T12:00:36","guid":{"rendered":"https:\/\/blogs.bmj.com\/spcare\/?p=1324"},"modified":"2017-12-14T11:55:00","modified_gmt":"2017-12-14T11:55:00","slug":"news-and-updates-from-www-palliativedrugs-com-99","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/spcare\/2018\/01\/05\/news-and-updates-from-www-palliativedrugs-com-99\/","title":{"rendered":"News and updates from www.palliativedrugs.com"},"content":{"rendered":"

Selected items from the News and Latest Additions sections of www.palliativedrugs.com<\/a>,<\/strong><\/em>
\nthe world\u2019s leading palliative care website with over 30,000 members from 169 Countries.<\/strong><\/em><\/p>\n

Safety updates<\/h4>\n

Buccolam pre-filled syringes: medicines defect information<\/strong>
\nMHRA has highlighted reports that the translucent tip-cap of Buccolam (midazolam) oromucosal
\nsyringes (all strengths) sometimes remains on the syringe tip when the red outer cap is pulled off.
\nThe translucent tip cap must be removed manually to enable the administration of Buccolam, and
\nprevent it falling into the patient\u2019s mouth upon application of extreme pressure. Health
\nprofessionals, patients and carers should be advised to check that the tip cap has been removed
\nbefore attempting administration. For more information, click here<\/a>.<\/p>\n

Calcichew-D3 500mg\/400 IU caplets (Takeda) batch recall<\/strong>
\nTakeda UK are recalling a specific batch of calcichew-D3 500mg\/400 IU caplets due to traces of a
\nnon-approved excipient (not thought to pose a significant risk to health).
\nBatch number: 11372123, Expiry date: May 2019, Distribution since: 15 November 2017. For more
\ninformation, click here<\/a>.<\/p>\n

Hot Topics<\/h4>\n

Cochrane review: ketamine as an adjuvant to opioids for cancer pain<\/strong>
\nThis review (last updated in 2012) has been published in full on-line. The authors conclude that
\nthere is still insufficient evidence to assess the benefits and harms of ketamine as an adjuvant to
\nopioids for the relief of refractory cancer pain. The evidence is very low quality. Rapid dose
\nescalation of ketamine to high-dose (500mg) does not appear to have clinical benefit and may be
\nassociated with serious undesirable effects. More randomized controlled trials regarding specific
\nlow-dose ketamine clinical regimens in current use are needed. For more information, click here<\/a>.<\/p>\n

Items which should not be routinely prescribed in primary care<\/strong>
\nNHS England and NHS Clinical Commissioners have now published guidance for Clinical
\nCommissioning Groups (CCGs) on items which should not be routinely prescribed in primary care.
\nThis follows a recent consultation (see our news item<\/a>). The list includes items which may be
\nrelevant to palliative care. Since the consultation, slight changes to the guidance for fentanyl
\nimmediate-release products and lidocaine patches have been made (see below).
\nIn summary, it is now recommended that prescribers in primary care should not initiate the
\nfollowing products for any new patient and that CCGs should support the deprescribing of these
\nproducts:
\n\uf0b7 immediate-release fentanyl products; unless for palliative care and in line with NICE guidance
\nand in conjunction with specialist recommendation
\n\uf0b7 lidocaine plasters \u2013 unless for post herpetic neuralgia in line with NICE guidance
\n\uf0b7 oxycodone and naloxone combination products
\n\uf0b7 rubefacients (excluding topical NSAIDs)
\n\uf0b7 tramadol and paracetamol combination products.
\nNote. If, in exceptional circumstances, there is a clinical need for immediate-release fentanyl,
\nlidocaine plasters or oxycodone\/naloxone combination products to be prescribed in primary care,
\nthis should be undertaken in a co-operation arrangement with a multi-disciplinary team and\/or
\nother health professional.
\nOther products covered in the guidance are: coproxamol, dosulepin, doxazosin modified-release,
\nglucosamine and chondroitin, herbal treatments, homeopathy, liothyronine, lutein and antioxidants,
\nomega-3 fatty acid compounds, perindopril arginine, tadalafil (once daily), travel vaccines,
\ntrimipramine.
\nA further consultation on the prescribing of over-the- counter products is expected. For more
\ninformation, click here<\/a>.<\/p>\n

Drug Updates<\/h4>\n

SMC accepts Epistatus 10mg oromucosal solution<\/strong>
\nThe Scottish Medicines Consortium (SMC) has accepted the Epistatus \u00ae brand of midazolam 10mg
\noromucosal solution for buccal administration for the treatment of prolonged, acute seizures in
\nchildren and adolescents aged 10 to &lt;18 years.
\nNote. This product was authorized earlier in 2017 (see our news item<\/a>). Epistatus \u00ae oromucosal
\nsolution is 10mg\/mL; this is double the concentration of the other authorized formulation of
\nmidazolam oromucosal solution (Buccolam \u00ae ) in the UK, which is 5mg\/mL and available as 2.5mg,
\n5mg, 7.5mg and 10mg prefilled oral syringes. For more information, click here<\/a>.<\/p>\n

Tranexamic acid 500mg tablet shortage<\/strong>
\nWe understand that there are currently limited supplies of generic tranexamic acid 500mg tablets
\ndue to a difficulty in manufacturers obtaining raw materials. Some supplies of branded tranexamic
\nacid 500mg tablets (Cyklokapron \u00ae ), over the counter product (Cyklo-f \u00ae ) and some generic
\ntranexamic acid 500mg tablets may still be available, however intermittent supply issues are
\nexpected until at least 2018. For more information, click here<\/a>.<\/p>\n

SIGN guidelines on the management of diabetes<\/strong>
\nSIGN 116 guideline: management of diabetes has been updated. In addition, a new guideline,
\nSIGN 154: pharmacological management of glycaemic control in people with type 2 diabetes, has
\nbeen published. For more information, click here<\/a>.<\/p>\n

Latest Editions<\/h4>\n

Sublingual opioids: alfentanil, fentanyl and sufentanil \u2013 Do you use them?<\/strong>
\nResults from our survey<\/a> (September- November 2017).<\/p>\n

Submit your levetiracetam combinations to the SDSD<\/strong>
\nWe have added levetiracetam to the drug selection list on our syringe driver survey database
\n(SDSD)<\/a>. We are now able to accept and display anecdotal compatibility information on the
\ncombination of levetiracetam with other drugs. For more information on the use of levetiracetam
\nvia CSCI, see the PCF6 levetiracetam<\/a> monograph.<\/p>\n

On-line PCF updated monographs<\/strong>
\nThe Palliative Care Formulary is continually reviewed and updated over a three year cycle. These
\nupdates are published regularly on-line, with the whole book published in print every three years.
\nA large number of updated monographs were added to the website during September 2017 in
\npreparation for the 6 th edition of the Palliative Care Formulary print publication PCF6<\/strong>.
\nThe following two documents are a full list of all the monographs updated, since the publication of
\nPCF5 in 2014, in either alphabetical, or chronological, order.
\nPCF6<\/strong><\/em> print edition, now available for order from our website store<\/a> for \u00a355 (including p&amp;p in the
\nUK), reflects the content of the on-line PCF<\/a> on www.palliativedrugs.com website as of the end of
\nSeptember 2017.
\nPCF updated website monographs (alphabetical list<\/a>)
\nPCF updated website monographs (chronological list<\/a>)<\/p>\n

Follow us on twitter @palliativedrugs for the latest updates.<\/p>\n

Prepared by Sarah Charlesworth and Andrew Wilcock<\/p>\n","protected":false},"excerpt":{"rendered":"

Selected items from the News and Latest Additions sections of www.palliativedrugs.com, the world\u2019s leading palliative care website with over 30,000 members from 169 Countries. Safety updates Buccolam pre-filled syringes: medicines defect information MHRA has highlighted reports that the translucent tip-cap of Buccolam (midazolam) oromucosal syringes (all strengths) sometimes remains on the syringe tip when the […]<\/p>\n

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