pcf6 palliative care formulary

30 Pages·2017·0.22 MB·English

PCF6
PALLIATIVE
CARE
FORMULARY
Published by palliativedrugs.com Ltd.
Palliativedrugs.com Ltd
Hayward House Study Centre
Nottingham University Hospitals NHS Trust, City Campus
Nottingham NG5 1PB
United Kingdom
www.palliativedrugs.com
© palliativedrugs.com Ltd 2017
The moral rights of the editors have been asserted.
PCF5+ PDF 2016
PCF5+ PDF 2015
PCF5 2014, reprinted 2015
PCF4+ PDF 2013
PCF4+ PDF 2012
PCF4 2011, reprinted 2012 (twice), 2013
PCF3 2007, reprinted 2008, 2009
PCF2 2002, reprinted 2003
PCF1 1998
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British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library.
ISBN 978-0-9928467-4-9
Typeset by Anytime Publishing Services, Leicestershire, UK
Printed by Halstan Printing Group, Amersham, UK
DISCLAImEr
DISCLAIMER
Every effort has been made to ensure the accuracy of this text, and that the best information
available has been used. However, palliativedrugs.com Ltd neither represents nor guarantees
that the practices described herein will, if followed, ensure safe and effective patient care. The
recommendations contained in this book reflect the editors’ judgement regarding the state of
general knowledge and practice in the field as of the date of publication. Information in a book of
this type can never be all-inclusive, and therefore will not cover every eventuality.
Thus, those who use this book must make their own determinations regarding specific safe and
appropriate patient-care practices, taking into account the personnel, equipment, and practices
available at the hospital or other facility at which they are located. Neither palliativedrugs.com
Ltd nor the editors can be held responsible for any liability incurred as a consequence of the use
or application of any of the contents of this book. mention of specific product brands does not
imply endorsement.
Particularly when prescribing a drug for the first time, a doctor (or other independent
prescriber) should study the contents of the manufacturer’s Summary of Product Characteristics
(SPC), paying particular attention to indications, contra-indications, cautions, drug interactions,
and undesirable effects.
PCF6 iii
EDITorIAL STAFF
EDITORIAL STAFF
Editors-in-Chief
Robert Twycross Dm, FrCP
Emeritus Clinical reader in Palliative medicine, oxford University
Andrew Wilcock Dm, FrCP
macmillan Clinical reader in Palliative medicine and medical oncology, Nottingham
University
Consultant Physician, Hayward House, Nottingham University Hospitals NHS Trust
Paul Howard BmedSci, mrCP
Consultant in Palliative medicine, Earl mountbatten House, Isle of Wight NHS Trust
Senior Editor
Sarah Charlesworth BPharm, DipClinPharm, mrPharmS
Specialist Pharmacist, Palliative Care Information and Website management, Hayward
House, Nottingham University Hospitals NHS Trust
Editor
Claire Stark Toller mA, mA, mrCP
Consultant in Palliative medicine, Countess mountbatten House, University Hospital
Southampton NHS Foundation Trust
Associate Editor
Julie Mortimer BPharm, mrPharmS
malcolm mortimer media, Nottingham (former Senior Editor)
Production Editor
Sarah Keeling
Publishing office manager, Palliativedrugs.com Ltd. Hayward House, Nottingham
University Hospitals NHS Trust
Editorial Board
Jason Boland PhD, FrCP, FHEA
Senior Clinical Lecturer and Honorary Consultant in Palliative medicine, Hull York
medical School, University of Hull, UK
Andrew Broadbent BmedSc, mHm, FrACP, FAChPm
Honorary Adjunct Associate Professor, Bond University and Gold Coast Health, robina
Hospital, Australia
Virginia Bray mrCP
Specialist registrar in Palliative medicine, Hayward House, Nottingham University
Hospitals NHS Trust, Nottingham, UK
Alpna Chauhan mrCP
Consultant in Palliative medicine, John Eastwood Hospice, Sutton-in-Ashfield, UK
iv www.palliativedrugs.com
EDITorIAL STAFF
Brian Creedon mmedSci, mrCPI
Consultant in Palliative medicine, Waterford regional Hospital, Waterford, Ireland
Vincent Crosby FrCP
Consultant in Palliative medicine, Hayward House, Nottingham University Hospitals
NHS Trust, Nottingham, UK
Andrew Davies mSc, mD, FrCP
Consultant in Palliative medicine, royal Surrey County Hospital, St. Luke’s Cancer
Centre, Guildford, UK
Joanne Droney PhD, mrCPI
Consultant in Palliative medicine, royal marsden Hospital, London, UK
Jo Elverson mA(Ed) mrCP
Consultant in Palliative medicine, Helen and Douglas House Hospices for Children &
Young Adults, oxford, UK
Ruth England FrCP
Consultant in Palliative medicine, Derby Hospitals NHS Trust, Derby, UK
Caroline Facey mrCP
Specialist registrar in Palliative medicine, Hayward House, Nottingham University
Hospitals NHS Trust, Nottingham, UK
Louise Free mSc, mrCP
Consultant in Palliative medicine, St Wilfrids Hospice and East Sussex NHS Trust,
Eastbourne, UK
Catherine Gwilt mA BSc mrCP
Consultant in Palliative medicine, St Joseph’s Hospice, London, UK
Janet Hardy BSc, mD, FrACP
Professor of Palliative medicine, University of Queensland and mater Health Services,
Brisbane, Australia
Vaughan Keeley PhD, FrCP
Consultant in Palliative medicine, Derby Hospitals NHS Trust, Derby, UK
Samuel King FrCP
Consultant in Palliative medicine, St Elizabeth Hospice and Ipswich Hospital Trust,
Ipswich, UK
Malgorzata Krajnik mD, PhD
Professor of Palliative medicine, Nicolaus Copernicus University and University Hospital
No 1, Bydgoszcz, Poland
Susie Lapwood mA, DFSrH, DipPallmed, mrCGP
Senior Speciality Doctor, Helen and Douglas House Hospices for Children & Young
Adults, oxford, UK
Mark Lee mD, mrCP
Consultant in Palliative medicine, St Benedict’s Hospice and Specialist Palliative Care
Centre, Sunderland, UK
Michael Lucey BmedSc, FrCPI
Consultant in Palliative medicine, milford Hospice, Limerick and HSE mid West, Ireland
PCF6 v
EDITorIAL STAFF
Staffan Lundstrom mD, PhD
Associate Professor, Karolinska Institutet and Stockholms Sjukhem, Stockholm, Sweden
Louise Lynch FrCA, FFPmrCA
Consultant in Chronic Pain management, Leeds Teaching Hospitals NHS Trust, UK
Laura Miller mSc, PgDip Dietetics
Team Lead Dietitian, Nottingham University Hospitals NHS Trust, Nottingham, UK
Simon Noble DipPallmed, mD, FrCP
Clinical Professor in Palliative medicine, Cardiff University, UK
Stephen Oxberry BSc (Hons), PhD, FrCP
Consultant in Palliative medicine, Kirkwood Hospice and Calderdale and Huddersfield
Foundation NHS Trust, Huddersfield, UK
Victor Pace DipPallmed, FrCP, FrCS
Consultant in Palliative medicine, St Christopher’s Hospice, London, UK
Maggie Presswood mrCP
Specialist registrar in Palliative medicine,Wales Deanery
Rachel Quibell mrCGP, FrCP
Consultant in Palliative medicine, Newcastle upon Tyne Hospitals NHS Foundation Trust,
Newcastle, UK
Joy Ross PhD, FrCP
Consultant in Palliative medicine, St Christopher’s Hospice, London, UK
Anna Spathis mSc, FrCP, mrCGP, FHEA
Consultant in Palliative medicine, Cambridge University Hospitals NHS Foundation Trust,
Cambridge, UK
Mark Taubert mSc, mrCGP, FrCP
Consultant in Palliative medicine, Velindre NHS Trust, Cardiff, UK
Jillian Wall mrCP
Specialist registrar in Palliative medicine, Hayward House, Nottingham University
Hospitals NHS Trust, Nottingham, UK
vi www.palliativedrugs.com
CoNTENTS
CONTENTS
Preface xi
How PCF is constructed xii
Getting the most out of PCF xiv
The use of medicinal products beyond (off-label) and without
(unauthorized) marketing authorization xix
Drug names xxv
Abbreviations xxvii
Part 1 Drug Monographs
1 Gastro-intestinal system 1
Antacids 1
Antimuscarinics 5
Prokinetics 24
H-receptor antagonists 27
2
Proton pump inhibitors 30
Loperamide 35
Laxatives 38
Products for haemorrhoids 56
Pancreatin 58
2 Cardiovascular system 61
Furosemide 61
Spironolactone 67
Systemic local anaesthetics 71
*Clonidine 77
Glyceryl trinitrate 81
Nifedipine 85
Anticoagulants 87
Haemostatics 101
3 Respiratory system 107
Bronchodilators 107
Inhaled corticosteroids 126
oxygen 130
Drugs for cough 140
PCF6 vii
CoNTENTS
4 Central nervous system 149
Benzodiazepines and Z-drugs 149
melatonin 164
Antipsychotics 168
Antidepressants 193
*Psychostimulants 225
*Cannabinoids 229
Anti-emetics 235
Anti-epileptics 256
5 Analgesics 295
Principles of use of analgesics 295
Adjuvant analgesics 299
Paracetamol 303
Nefopam 310
Non-steroidal anti-inflammatory drugs (NSAIDs) 312
Weak opioids 348
Strong opioids 360
opioid antagonists (therapeutic target within the CNS) 457
opioid antagonists (therapeutic target outside the CNS) 466
6 Infections 471
Antibacterials in palliative care 471
oral candidosis 475
metronidazole 478
rifampicin 481
Urinary tract infections 485
Cellulitis in a lymphoedematous limb 490
Clostridium difficile infection 496
7 Endocrine system and immunomodulation 501
Bisphosphonates 501
Systemic corticosteroids 513
Demeclocycline 524
Desmopressin 528
Drugs for diabetes mellitus 532
*octreotide 544
Progestogens 552
Danazol 556
*Thalidomide 558
viii www.palliativedrugs.com
CoNTENTS
8 Urinary tract disorders 565
Tamsulosin 565
oxybutynin 567
methenamine hippurate 570
Catheter patency solutions 572
Discoloured urine 573
9 Nutrition and blood 575
Anaemia 575
Ascorbic acid (vitamin C) 581
Phytomenadione (vitamin K) 582
1
Potassium 585
magnesium 588
Zinc 594
10 Musculoskeletal and joint diseases 599
Depot corticosteroid injections 599
rubefacients and other topical products 601
Skeletal muscle relaxants 605
11 Ear, nose and oropharynx 615
mouthwashes 615
Artificial saliva 616
Pilocarpine 618
Drugs for oral inflammation and ulceration 619
Cerumenolytics 624
12 Skin 627
Emollients 627
Topical antipruritics 635
Barrier products 638
13 Anaesthesia 641
*Ketamine 641
*Propofol 651
Part 2 Prescribing in palliative care
14 Prescribing in palliative care 657
15 Anticipatory prescribing in the community 671
16 Prescribing in children 675
17 renal impairment 681
18 Hepatic impairment 703
PCF6 ix
CoNTENTS
19 Variability in response to drugs 717
20 Prolongation of the QT interval in palliative care 731
21 Drug-induced movement disorders 739
22 Drugs and fitness to drive 743
23 Taking controlled and prescription drugs to other countries 749
24 obtaining specials 751
25 management of postoperative pain in opioid-dependent patients 753
26 Drugs for pruritus 757
27 oral nutritional supplements 767
Part 3 Routes of administration
28 Drug administration to patients with swallowing difficulties 785
or enteral feeding tubes
29 Continuous subcutaneous drug infusions 817
30 Transdermal patches 831
31 Nebulized drugs 835
32 Spinal analgesia 839
Appendices
A1 Anaphylaxis 851
A2 opioid dose conversion ratios 855
A3 Compatibility charts 863
Indexes
Drugs 881
Topics 887
x www.palliativedrugs.com