pcf6 palliative care formulary PDF
Preview pcf6 palliative care formulary
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 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise without the prior permission in writing of palliativedrugs. com Ltd or as expressly permitted by law, or under terms agreed with the appropriate reprographics rights organization. Enquiries concerning reproduction outside the scope of the above should be sent to [email protected] or by ordinary mail to the above address. 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
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