Nice will not be purchasing the march 2014 edition for nationwide distribution to nhs health professionals in england. Fentanyl intranasal spray (instanyl) may be suitable for shared care but should be initiated by, and remain under the supervision of a physician experienced in the management of opioid therapy in cancer patients. The ukmi safety assessment report summarizing the changes to dexamethasone injection in the uk (see our ) has been updated.
A therapeutic review on paracetamol (acetaminophen) has been published in the journal of pain and symptom management (jpsm) this is the 15th article in the series all are based on monographs featured in the palliative care formulary. This updates and replaces recommendations on the drug treatment of painful diabetic neuropathy in previous nice clinical guidelines (cg15 and cg87). The latest drug and therapeutics bulletin (dtb) examines the place of the cannabinoid product, sativex (gw pharma, uk) in multiple sclerosis.
The boxed warning will remind practitioners that due to the risks of intravenous injection, the preferred route of administration is deep intramuscular injection and that subcutaneous injection is contraindicated. The latest drug and therapeutics bulletin features part 1 of two articles on the treatment of neuropathic pain and features the use of antidepressants. The european commission is considering suspending all licenses for oral ketoconazole, however, arrangements are being put in place to ensure patients with cushingâs syndrome using oral ketoconazole off-label continue to have access to this product.
Mhra recommend liver-function tests should be done in all patients taking tolvaptan who report signs or symptoms that suggest liver injury and tolvaptan suspended during investigations. The booklet accompanies the sign guideline on this topic published in november 2008 (see news item ), both can be downloaded from the sign website link below. The thalidomide monograph has been fully updated and has been published in the journal of pain and symptom management (jpsm) as a therapeutic review.
This follows concerns highlighted in 2012 that domperidone is associated with a small increased risk of serious cardiac undesirable effects. Naloxegol was recently launched in the uk (see our news item mhra have warned that osteonecrosis of the external auditory canal has been reported very rarely (2 years. The association for childrens palliative care (act) has launched a good practice tool to help professionals prepare when they are caring for a child in the last hours and days of their life.
Thalidomide pharmion (celgene 08448 010045), and must be prescribed and dispensed in accordance with the thalidomide pharmion pregnancy prevention programme. Analytical testing of counterfeits, with this batch number, has indicated that some parts of the counterfeit product are genuine. Hydrocodone combination products have been rescheduled in the usa to schedule 2 controlled substances (formerly schedule 3). The national institute for health and clinical effectiveness (nice) has produced a new medicine evidence summary for this product which can be accessed from the link below. Nycomed has launched instanyl (fentanyl) single-dose nasal spray for the management of breakthrough pain in adults already receiving maintenance opioid therapy for chronic cancer pain.
The company plans to reduce the maximum daily dosage of regular strength tylenol and other products containing acetaminophen (paracetamol) in 2012. The governments current preference is to restrict imports of oxycodone from outside the eea and preserve the supply of diamorphine to the nhs. The uk medicines and healthcare products regulatory agency (mhra) have issued a class 4 drug alert (caution in use) for the matrifen brand of fentanyl 100microgramh transdermal patches (takeda uk, teva livery 01628 537900 ). The authors have concluded that there was very limited evidence that oxycodone (as oxycodone mr) may provide moderate benefit (equivalent to a 30 reduction in pain) to people with painful diabetic neuropathy or postherpetic neuralgia. Full details of the recall can be obtained from the mhra website link below.
If you are a uk practitioner, we would be grateful if you would spend a few moments giving us your opinion. The national institute for health and care excellence (nice) has published its evidence summary (esuom16) for the unauthorized (unlicensed)off-label use of oral glycopyrronium bromide for hyperhidrosis. The journal will publish articles that are relevant to clinical practice and clinical service development including transitional research, clinical trials, epidemiology, behavioural sciences, health service research, ethics, reviews, and comment. It states that for patients in whom the combination of bupivacaine and fentanyl is an appropriate choice of therapy, bufyl the all wales medicines strategy group (awmsg) does not recommended capsaicin 8 patch (qutenzaâ astellas pharma, staines, middlesex, uk) as an option, within nhs wales, for use on its own for the treatment of peripheral neuropathic pain (pnp) in non-diabetic adults. Pregabalin modified-release tablets (lyrica cr pfizer) have been approved in the us.
The world health organization (who) has published a package on the pharmacological treatment of persisting pain in children with medical illnesses, which replaces the previous guidelines cancer pain relief and palliative care in children. The scottish medicines consortium (smc) has accepted diamorphine nasal spray (ayendi) for the treatment of acute severe nociceptive pain in children and adolescents in a hospital setting. End of life care for infants, children and young people with life-limiting conditions planning and management we would like to encourage all members to complete our annual website satisfaction survey to enable us to help shape the way that palliativedrugs. The association for childrens palliative care (act) has produced model resuscitation plans for children and young people in palliative care. A summary and the full guideline can be downloaded from both the bts and the sign websites. They are some local reports of supply difficulties, however, sanofi have confirmed that their product (nozinan) is in stock and available to order and they are unaware of any wholesaler restrictions. The unit contains 80 doses and allows a maximum of 6 dosesh (240microgramh). In addition the 100ml infusion bags (containing 1g paracetamol) should only be used in patients weighing 33kg. Palonosetron capsules (aloxi, is pharmaceuticals) have been launched in the uk for the prevention of nausea and vomiting associated with moderately emetogenic cancer chemotherapy in adults. Health professionals can now access the british national formulary for children (bnfc) from a smartphone or tablet via a new application (app) from the national institute for health and clinical excellence (nice).NHS organisations are strongly requested to order as normal and not to stockpile , .... Tolvaptan 7.5mg tablets have been launched to add to the 15mg and 30mg tablets .... which is 5mg/mL and available as 2.5mg, 5mg, 7.5mg and 10mg prefilled oral syringes. ...... Dr Katherine Oakley, St Helena Hospice, Colchester, Essex.