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Royal United Hospitals Bath NHS Foundation Trust
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 Formulary Chapter 21: Palliative Care Formulary - Full Chapter
Notes:

APRIL 2020 BSW End of life COVID palliative care guidance EOL COVID prescription support v5 Note this contains options that may be suitable to use in EoL patients with swallowing difficulties and where syringe drivers may be unavailable.

NICE NG163 - COVID-19 rapid guideline: managing symptoms (including at the end of life) in the community

The Wessex Palliative Care handbook contains guidance to help GPs, community nurses and hospital staff as well as specialist palliative care teams. It aims to provide a checklist for the management of common problems in palliative care, with some information on drug treatment. It is not a comprehensive textbook. The Palliative Care Handbook: A Good Practice Guide Wessex Palliative Physicians Ninth Edition 2019 

For contact details of hospices and emergency drug lists and pharmacies participating across Bath, Swindon and Wiltshire scroll to bottom of chapter or click here Community Pharmacy Emergency Drugs List & Contact Details

 Details...
21.03  Expand sub section  Just In Case Prescribing Primary Care
 note 

Just in Case Bags / Box formalise anticipatory prescribing at the end of life, and can minimise distress to the patient and their family, should there be a sudden deterioration when medications are not easily accessible.

The prescriber should ensure that all relevant agencies are informed that the Just in Case Bag / Box is within the care setting. The patient must be reviewed within 24 hours of medication being administered from the bag. The Just in Case Bag / Box prescription should be reviewed every 4 weeks

Controlled Drug Morphine (Injections 10mg /ml)
View adult BNF View SPC online
Formulary
Green
  • Community Just In Case Boxes
  • For pain
  • Use first line
 
   
Cyclizine 
(Injection 50mg/ml)
View adult BNF View SPC online
Formulary
Green
  • Community Just In Case Boxes
  • For nausea and vomiting
 
   
Controlled Drug Diamorphine (Injections 10mg /ml)
View adult BNF View SPC online
Formulary
Green
  • Current supply issues - use Morphine first line
  • Community Just In Case Boxes
  • For pain
 
   
Haloperidol  
(Injection 5mg/ml )
View adult BNF View SPC online
Formulary
Green
  • Community Just In Case Boxes
  • For hallucinations and agitation
 
   
Hyoscine Butylbromide

(Injection 20mg/ml )
View adult BNF View SPC online
Formulary
Green
  • Community Just In Case Boxes
  • For respiratory tract secretions
  • For colic/reduce secretions in inoperable bowel obstruction
 
   
Hyoscine Hydrobromide

(Injection 400mcg/ml)
View adult BNF View SPC online
Formulary
Green
  • Community Just In Case Boxes
  • For respiratory tract secretions
 
   
Levomepromazine 
(Injection 25mg/ml)
View adult BNF View SPC online
Formulary
Green
  • Community Just In Case Boxes
  • For nausea and vomiting
 
   
Controlled Drug Midazolam 
(Injection 10mg/2ml )
View adult BNF View SPC online
Formulary
Green
  • Community Just In Case Boxes
  • For restlessness, anxiety and agitation
 
   
 ....
Key
note Notes
Section Title Section Title (top level)
Section Title Section Title (sub level)
First Choice Item First Choice item
Non Formulary Item Non Formulary section
Restricted Drug
Restricted Drug
Unlicensed Drug
Unlicensed
Track Changes
Display tracking information
click to search medicines.org.uk
Link to adult BNF
click to search medicines.org.uk
Link to SPCs
SMC
Scottish Medicines Consortium
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
High Cost Medicine
High Cost Medicine
Cancer Drugs Fund
Cancer Drugs Fund
NHSE
NHS England
Homecare
Homecare
CCG
CCG
Blueteq
High Cost Drug Approval System

Traffic Light Status Information

Status Description

Red

RED - Hospital only to be prescribed by a specialist and supplied from secondary care ONLY throughout treatment.  

Amber

Amber medicines are considered suitable for GP prescribing following specialist initiation or recommendation.  

Amber with Shared Care

Shared Care - these medicines require specialist initiation and stabilisation. Ongoing division of responsibility for drug and disease monitoring between specialist and GP by a Shared Care Guideline (SCG). If no SCG in place status reverts to red.  

Green

These medicines are appropriate for initiation in both primary and secondary care. Prescribing is appropriate within licensed or local recommendations.  

Self

Suitable for patient to be directed to buy themselves  

Grey

Not currently used. We intend to include this TLS in future to highlight where a decision to use this medicine is under review.   

Black

Not currently used. We intend to include this TLS in future to highlight where a decision has been made by either or both the local or national NHS not to routinely commission this preparation for its licensed indications. Do not prescribe.  

Red Specialist Centre

Not currently used. We intend to include this TLS in future to highlight where this medicine and indication is ONLY available through a Specialist Centre according to a NICE Highly Specialised Technology or NHSE Specialised Commission Circular / Policy.  

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