Syringe driver survey - help needed please
12th February 2009
Calling all members!
We are running the next palliativedrugs.com syringe driver survey throughout March/April 2009 and need as many people as possible to collect data on Continuous Subcutaneous Infusions (CSCI) prescribed in their units for 4 weeks during this time.
We feel it is particularly important to collate as much compatibility data as possible whilst the MHRA are reviewing the practice of mixing medicines, to demonstrate the extent to which this method of administration is used and the wealth of knowledge and practice available.
We have run the survey twice before with the help of www.palliativedrugs.com members from all over the world and this led to the setting up of our syringe driver survey database (SDSD) and also updating the compatibility charts for PCF3 and this website.
Please help us gather compatibility data which will benefit all members searching the SDSD and add to the body of clinical experience that the MHRA may draw upon.
If you would be prepared to be involved in the 4 week data collection survey please contact firstname.lastname@example.org for further details. A copy of the form that will be used to record each CSCI is available to download from the link below, if possible we also ask that the data is added to the SDSD before sending us the completed forms, so that we can cross-check the entries.
If you are unable to help with the survey, please remember we welcome the addition of any drug combinations to the SDSD at any time, particularly those for which we have little or no data.
SIGN booklet on cancer pain for patients and carers
10th February 2009
The Scottish Intercollegiate Guidelines Network (SIGN) has published a booklet for patients and carers on cancer pain. The booklet accompanies the SIGN guideline on this topic published in November 2008 (see news item 2008-11-14), both can be downloaded from the SIGN website link below.
NLH: new section on GI symptoms
9th February 2009
The National Library for Health (NLH) palliative and supportive care specialist library has produced the first annual evidence update on 'gastrointestinal symptoms in supportive and palliative care'. It collects together evidence on nausea and vomiting, constipation and bowel obstruction.
Fentanyl sublingual tablets (Abstral) launched in UK
5th February 2009
Fentanyl (as citrate) sublingual tablets (Abstral, Prostrakan 01896 664000) have been launched in the UK and are licensed for the management of breakthrough pain in adult patients using opioid therapy for chronic cancer pain.
The SPC describes maintenance opioid therapy as those who are taking at least 60mg of oral morphine daily, at least 25microgram of transdermal fentanyl per hour, or an equianalgesic dose of another opioid, for a week or longer.
The initial dose of Abstral should be 100microgram, titrating upwards as necessary through the range of available tablet strengths (100, 200, 300, 400, 600, 800microgram) to an effective dose (see the SPC below for full details of the method of titration). The SPC states that switching from other fentanyl containing products to Abstral must not occur at a 1:1 ratio because of different absorption profiles. If patients are switched from another fentanyl containing product, a new dose titration with Abstral is required.
Abstral sublingual tablets come in packs of 10 (100, 200, 300, 400microgram) and 30 (all strengths). The cost of 1 tablet (regardless of strength) is £4.99.
Another fentanyl tablet for breakthrough pain was also recently launched (see news item 2009-01-22).
Piroxicam injection discontinued in UK
5th February 2009
Piroxicam (Feldene, Pfizer 01304 616161) intramuscular injection 20mg/ml will no longer be available from March 31st 2009 due to commercial reasons. Other presentations of piroxicam (capsules and melt tablets) will still be available.
Docusate sodium micro-enema updated SPC
5th February 2009
The UK SPC for docusate sodium micro-enema (Norgalax, Norgine 01895 826600) has been updated. The use of docustae sodium micro-enema is now contraindicated in: haemorrhoids, anal fissures, rectocolitis, anal bleeding, abdominal pain, intestinal obstruction, nausea, vomiting, inflammatory bowel disease, ileus and known hypersensitivity to any of the ingredients.
- MHRA infusion device warning with 50mL syringes
- Thalidomide: increased risk of haematological second primary malignancies
- Tolvaptan: risk of liver injury
- MHRA caution in use alert: lorazepam injection 4mg/mL
- Cochrane review: levomepromazine for nausea and vomiting in palliative care
- Cyclizine 50mg/mL injection resolved supply problem
- Sativex reclassified as schedule 4 part 1 Controlled Drug
- Japanese translation of PCF now available!
- Die März/April Ausgabe des APM Newsletter ist fertig
- Buprenorphine therapeutic review