Palliative Care Malignant

WoundsCompounding Pharmacy’s Approach

Dennis Wong, B.Sc. (Pharm.) CD Whyte Ridge Pharmacy

123 G Scurfield Blvd., Winnipeg(204)-488-1819

cindenrx@mts.net

- Incident Pain Medications

- Topical Dosage Forms

- Medications and Bases

Incident Pain Medications

Fentanyl, Sufentanil Sublingual

- Short acting opioids, injectable

- Works within 10 to 15minutes and last about ~ 1 hour

- Hold liquid under the tongue for about 10

minutes if possible without swallowing it

- May be repeated up to two more doses at

10-15 minutes intervals

- Flavoured Fentanyl SL, Lollipops, Lozeges

- Nasal Spray

- Sufentanil in metered dose nasal

sprayer which delivers 0.1mL per spray

- one or more sprays approximately 10

to 15 minutes prior to activity.

Incident Pain Protocol (www.palliative.info)

Topical Dosage Forms

• Topical Sprays

• Wound Dressing Gels

• Radiation Burn Gel

• Mouthwash, Mouth Gel

• Topical Spray

- 0.1mL per spray

- 2 to 4 sprays to surrounding area or

specific painful spots

• Wound Dressing gel

- Aqueous gel, Glycol base Gel

- Polyox Bandage

• Radiation Burn gel

- protective artificial skin layer

• Mouthwash

- medications to coat the mouth,

treat pain, infections

• Mouth Gel

- slow released protective coating

Medications and Bases

• Topical Sprays

- Morphine Sulfate, Hydomorphone HCl,

Methadone HCl

- Normal Saline, Proplylene Glycol, Ethoxy

Diglycol, DMAE

• Wound Dressing Gels

- Lidocaine, Tetraciane, Morphine Sulfate,

Hydromorphone HCl, Methadone HCl

• For Bed Sore Ulcer Wounds

- same pain medications

- Aloe Vera, Phenytion, Misoprostol

• Metronidazole Base

• Bases

- Intrasite Gel, Cellulose (Med Visc)

Gel, Propylene Glycol, Ethoxy

Diglycol, DMAE

• Radiation Burn Gel

- Lidocaine, Tetracaine, Morphine,

Hydromorphone, NSAID, Antibiotics,

Aloe Vera

- Pluronic F127 Gel (Carbomer Gel)

• Mouthwash

- Tetracaine HCl, Corticosteroids,

Anti-fungal, Anti-viral, Antibiotics,

Anti-histamine, Sucralfate

- Anti-foaming mouthwash base

• Mouth Gel

- Morphine Sulfate, Hydromorphone

HCl, Glycerin, Lemon

- Bioadhesive Slow Released Gel

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Member of Professional Compounding Centre of America (PCCA)

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