Guidelines : Pain

Detail

Condition :

Pain

Keywords :

PNMP, Ibuprofen, Naproxen, Tramadol, Buprenorphine, Morphine, Oramorph, Paracetamol, NSAIDs, Opioids, analgesia, analgesics, codeine phosphate, dihydrocodeine, co-codamol, co-dydramol, fentanyl, postherpetic neuralgia , PHN, post herpetic neuralgia, neuropathic pain, nerve pain, tricyclics, tricyclic antidepressants, TCA, amitriptyline, imipramine, nortriptyline, gabapentin, pregabalin, neurontin, lyrica, duloxetine, cymbalta, Diabetes, diabetic neuropathy, opioid patches

BNF Codes :

040701 - Non-Opioid Analgesics And Compound Prep
040702 - Opioid Analgesics
040703 - Neuropathic Pain

Committee Recommendations

Date

Committee Name

Narrative

Traffic Light Status

09 August 2023

Surrey Heartlands Medicines Safety Committee (MSC)

The Centre for Perioperative Care position statement on Modified Release Opioids - was agreed for use within Surrey Heartlands to support the safe use of opioids after surgery. See link

https://cpoc.org.uk/sites/cpoc/files/documents/2023-05/CPOC%20MR%20Opioid%20statement.pdf

N/A

08 June 2022

Surrey Heartlands Medicines Safety Committee (MSC)

Prescribing weight-adjusted oral paracetamol in adults - British Hepatology Pharmacy Group Position Statement - was agreed for use within Surrey Heartlands to support the safe use of paracetamol. See link below.

N/A

09 February 2022

Surrey Heartlands Medicines Safety Committee (MSC)

The ‘OPIOID PATCH INFORMATION TO KEEP PATIENTS SAFE' leaflet for patients and 'OPIOID PATCH SAFETY: COUNSELLING CHECKLIST’ for healthcare professionals were agreed for use within Surrey Heartlands to support the safe use of opioid patches. See documents below.

N/A

02 December 2020

Surrey Heartlands Integrated Care System Area Prescribing Committee (APC)

The local guidelines for persistant non-malignant pain have been updated . A link to the opioid dose conversion from the Faculty of Pain Medicine has been included (Appendix 5) and a link is also provided below for reference- see guidelines and other pain resources below

N/A

04 December 2019

Surrey & North West Sussex Area Prescribing Committee (formerly Prescribing Clinical Network)

The Surrey & Sussex Area Prescribing Committee have made recommendations in relation to paracetamol dosing in frail elderly patients.

There have been some case reports of liver failure associated with therapeutic doses of paracetamol in some patients. Frail elderly patients with a body-weight < 50kg and those with risk factors for hepatotoxicity such as cardiac, pulmonary and renal insufficiency in conjunction with old age, co-administration of medicines that induce liver enzymes, hepatitis and chronic alcohol consumption.

The BNF recommends that clinical judgement should be used to adjust the dose of oral paracetamol in such patients. The clinicians may choose to either reduce the dosage or the frequency of administration of paracetamol. Co-administration of enzyme-inducing medications may also increase toxicity; paracetamol doses should be reviewed and reduced.

NOTE: Patients having IV paracetamol will already have had adjustments made based on body weight so no further adjustment should be required.

N/A