The Association of Paediatric Palliative Medicine - APPM

1 APPM Master Formulary 1 The Association of Paediatric Palliative Medicine Master Formulary 5th edition 2020 Published by APPM Hard Copy RRP - 49 / $59 Digital Copy Free Download APPM Master Formulary 2 Editor in Chief Dr Satbir Singh Jassal MBE Medical Director Rainbows Hospice for children and Young People Loughborough Deputy Editor Dr Lynda Brook Macmillan Consultant in Paediatric Palliative Care Alder Hey children 's hospital Specialist Palliative Care Team Liverpool Principal Pharmacist Anita Aindow Senior Pharmacist Pharmacy Medicines Information Department Alder Hey children 's NHS Foundation Trust Liverpool Contributions from Dr Anna-Karenia Anderson Consultant in Paediatric Palliative Medicine The Royal Marsden NHS Foundation Trust, London Shooting Star children s Hospice, Surrey Dr Ella Aidoo Consultant in Paediatric Palliative Care Evelina London children s hospital London Dr Finella Craig Consultant in Paediatric Palliative Medicine great Ormond Street children 's hospital London Dr Richard Hain Consultant and Lead Clinician Paediatric Palliative Care children 's hospital .

2 Cardiff Visiting Professor University of South Wales Dr Emily Harrop Consultant in Paediatric Palliative Care Helen and Douglas House Hospice Care for children Oxford Dr Susie Lapwood Senior Associate Specialist Emeritus Helen and Douglas House Hospice Care for children Oxford APPM Master Formulary 3 Dr Heather McCluggage Associate Specialist in Paediatric Palliative Care Western Health and Social CareTrust Northern Ireland Dr Fauzia Paize Consultant Neonatologist Liverpool Women's NHS Foundation Trust Liverpool International Reviewers Prof. Adam Rapoport Medical Director Paediatric Advanced Care Team Associate Paediatric Professor University of Toronto Medical Director Emily s House children s Hospice Toronto, Canada Dr Michelle Meiring Consultant in Paediatric Palliative Medicine Director Paedspal Palliative Care unit Umduduzi Hospice for children Senior Lecturer in Palliaitive Medicine UCT Capetown, South Africa.

3 Dr Stefan J. Friedrichsdorf Medical Director, Department of Pain Medicine , Palliative Care & Integrative Medicine , children 's Hospitals and Clinics of Minnesota Associate Professor of Pediatrics, University of Minnesota Minnesota, USA Dr Dilini Rajapakse Consultant in Paediatric Palliative Medicine great Ormond Street hospital London Prof. Boris Zernikow Medical Director, German Paediatric Pain Centre children `s and Adolescent`s hospital , Datteln Chair children `s Pain Therapy and Paediatric Palliative Care Witten/Herdecke University, Faculty of Health, School of Medicine Germany Pharmacists Rupal Evans Specialist Pharmacist for children and Young People Royal Marsden hospital London Dr Kate McCuker PhD Lead Pharmacist CHAS Scotland APPM Master Formulary 4 Bhumik Patel Senior Specialist Pharmacist Palliative Care The Louis Dundas Centre great Ormond Street hospital NHS Foundation Trust Proof Readers Dr Clare Hale Deputy Medical Director Rainbows Hospice for children and Young People Loughborough Dr Susie Lapwood Senior Associate Specialist Emeritus Helen and Douglas House Hospice Care for children Oxford Previous contributions and

4 Peer reviews from Karen Bromley Previously Nurse Consultant in children and Young People's Palliative Care Helen and Douglas House Hospice Care for children Oxford Dr Patrick Carragher Medical Director CHAS Scotland Helen Crookes Ex-Lead Pharmacist CHAS Scotland Dr Mary Devins Consultant Paediatrician with a Special Interest in Paediatric Palliative Medicine Our Lady's children 's hospital , Crumlin and The Coombe Women & Infants Maternity hospital , Dublin ire Dr Siobhan Gallagher Consultant Paediatrician University hospital Limerick (UHL) / HSE Mid West Community Services ire Dr Mark Hunter Retired Medical Director Acorns children 's Hospice Trust Birmingham Dr Renee McCulloch Consultant in Paediatric Palliative Medicine great Ormond Street hospital London APPM Master Formulary 5 Dr Michael Miller Retired Consultant in Paediatric Palliative Medicine Martin House children and Young Persons Hospice Boston Spa.

5 Yorkshire Fiona Reid Diana children 's Nurse CHAS Scotland Peer review by Dr Megumi Baba Consultant in Paediatric Palliative Medicine Ty Hafan children s Hospice Wales Dr Karen Horridge Consultant Paediatrician (Disability) Sunderland Royal hospital Sunderland Dr Katrina Macdonald Hospice Doctor Little Harbour children s Hospice South West, Sr Austell England Dr Ullie de Saint-Quentin Paediatric Specialty Doctor Banbury hospital . Oxford APPM Master Formulary 6 Foreword It gives me great pleasure that we welcome the 5th edition of the APPM Master Formulary released on the 10th anniversary of the formation of the Association of Paediatric Palliative Medicine .

6 The Formulary has become an important core resource for the prescriber working in Paediatric Palliative Medicine . The Formulary brings together all available Paediatric Palliative prescribing information in a single volume, utilising up to date published research and consensus expert opinion. It continues to keep pace with new guidance on existing medication and introduces newer drugs pertinent to the field of Paediatric Palliative Medicine . In this edition, we welcome an increase in our pharmacy support, a neonatologist and an international contingent of reviewers. Their engagement ensures the Formulary continually raises the quality standard and maintains clinical relevance.

7 It is a reflection of the Formulary s success and impact that is now translated into several languages including Russian, Bahasa Indonesian and Spanish. The ethos of maintaining a formulary that is free to access and download will continue via the APPM website ( ). It is anticipated that revisions to the Formulary will now be every few years and a print format will be available to buy at cost via the APPM website. The APPM wishes to acknowledge the meticulous, diligent work of Dr Sat Jassal for coordinating, leading and editing all Formulary editions to date. We are very grateful for the excellent pharmacy support, led by Anita Aindow and to the many contributors and reviewers, old and new, for their hard work and analytical eye.

8 In particular we wish to thank our international colleagues for their input, whose insights and perspectives have been highly valuable. Finally thank you to the APPM membership for their peer review (and proof reading!) of the Formulary. As with all previous editions, the Association of Paediatric Palliative Medicine is pleased to support the new 5th edition APPM Master Formulary as a clinically relevant and up to date publication, providing support to all prescribers caring for infants, children and young people requiring Palliative care. Dr Anna-Karenia Anderson Chair of the Association for Paediatric Palliative Medicine APPM Master Formulary 7 Contents Foreword.

9 6 Introduction .. 11 Abbreviations .. 12 Formulary .. 13 Acetazolamide .. 13 Adrenaline .. 14 Alfentanil .. 15 Amitriptyline .. 18 Aprepitant .. 19 Arachis Oil Enema .. 20 Atropine .. 21 Baclofen .. 22 Bethanechol .. 23 Bisacodyl .. 24 Buprenorphine .. 25 Carbamazepine .. 27 Celecoxib .. 28 Chloral hydrate .. 29 Chlorpromazine .. 30 Clobazam .. 31 Clonazepam .. 32 Clonidine .. 34 Co-danthramer .. 37 Co-danthrusate .. 38 Codeine Phosphate .. 38 Cyclizine .. 39 APPM Master Formulary 8 Dantrolene .. 40 Dexamethasone .. 41 Diamorphine .. 43 Diazepam .. 45 Diclofenac Sodium .. 47 Dihydrocodeine .. 48 Docusate.

10 49 50 Entonox .. 51 Erythromycin .. 52 Etoricoxib .. 53 Fentanyl .. 54 Fluconazole .. 58 Fluoxetine .. 59 Gabapentin .. 60 Gaviscon .. 63 Glycerol (glycerin) .. 64 Glycopyrronium bromide .. 65 Haloperidol .. 67 Hydromorphone .. 69 Hyoscine butylbromide .. 70 Hyoscine hydrobromide .. 71 Ibuprofen .. 72 Ipratropium Bromide .. 74 Ketamine .. 75 Ketorolac .. 77 Lactulose .. 79 APPM Master Formulary 9 80 Levetiracetam .. 82 Levomepromazine .. 84 Lidocaine (Lignocaine) patch .. 86 Lomotil .. 87 Loperamide .. 88 Lorazepam .. 89 Macrogols .. 90 Melatonin .. 91 Methadone .. 92 Methylnaltrexone .. 96 Metoclopramide.