We mentioned this in a previous newsletter but another query has come in from our hospices which has led to a more thorough review. Proton Pump Inhibitors (PPIs) are used to treat gastroesophageal reflux disease and work by blocking the transport of acid into the stomach to decrease the acidity. They are used widely in…
Read More
We have had some interesting queries over the past few months which have required some time to answer in full. We also had some feedback from previous queries which we respond to below. All our visiting pharmacists are there to respond to your queries and if they can’t answer the question on the spot, we…
Read More
Advance planning for flu vaccination clinics has become an important part of patient care. The flu vaccination delivered in the following year provides vulnerable patients with protection against the strands of flu that are going to be the most prevalent over the next year. This is even more important this year, as hospitals deal with…
Read More
It is generally accepted that the management of symptoms in palliative care must involve appropriate polypharmacy. We are comfortable with using more than one medicine to help with one symptom provided the mechanisms of action are different and complementary – for example morphine plus gabapentin for pain with neuropathic characteristics. At the same time, we…
Read More
It’s summer and hay fever season is in full swing. Hay fever (allergic rhinitis) is an allergic reaction to pollen and symptoms include sneezing and coughing; a runny or blocked nose; itchy, red or watery eyes; an itchy throat, mouth, nose and ears; pain around your temples and forehead; headache; earache and feeling tired. People with asthma can experience additional symptoms…
Read More
We observe that people have a reduced oral intake at the end of life due to their symptoms or general weakness and level of consciousness. There is inconclusive evidence that artificial hydration is beneficial, with arguments against being the chance of it increasing the likelihood of oedema, ascites and death rattle. Arguments for are that it may alleviate feelings of thirst and reduce the risk of agitation.
Read More
Presentations at national conferences and courses can have a lasting influence on symptom management. Following a talk at one of the ‘Oxford’ courses(1), an increasing number of prescribers are now using ranitidine to reduce the secretions which make inoperable bowel obstruction such a challenging condition. Treatment in the past would often involve insertion of a nasogastric tube…
Read More
Ashtons provides a wide range of training courses, including e-learning and clinical training seminars. You can now choose from seven clinical training seminars including: Medicines management, Anaphylaxis, Diabetes and insulin, Drug interactions, Safer medicines administration, Controlled Drugs, Patient group directions. We have also added a smaller training course on cannabis…
Read More
This NICE guideline was published in October 2018 and although it is not aimed at palliative care patients it is worth noting that the use of nitrofurantoin MR 100mg BD is now regarded as preferable to trimethoprim as first line treatment. Trimethoprim resistance is more likely when used in the…
Read More