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Innovative Palliative Care Strategies for Managing Malignant Wounds: Compounding Pharmacy Techniques

Discover the comprehensive approach of Dennis Wong, B.Sc. (Pharm.) at Whyte Ridge Pharmacy in Winnipeg for managing malignant wounds through palliative care. This resource highlights the use of incident pain medications such as sublingual fentanyl and sufentanil nasal sprays, which provide rapid relief within 10 to 15 minutes. Learn about effective topical dosage forms, including wound dressing gels and radiation burn treatments, tailored to individual patient needs. Explore unique compounding options to enhance care for patients experiencing complex wound-related pain.

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Innovative Palliative Care Strategies for Managing Malignant Wounds: Compounding Pharmacy Techniques

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  1. 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

  2. Incident Pain Medications • Topical Dosage Forms • Medications and Bases

  3. 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

  4. 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)

  5. Topical Dosage Forms • Topical Sprays • Wound Dressing Gels • Radiation Burn Gel • Mouthwash, Mouth Gel

  6. 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

  7. Mouthwash - medications to coat the mouth, treat pain, infections • Mouth Gel - slow released protective coating

  8. 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

  9. 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

  10. 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

  11. Mouth Gel - Morphine Sulfate, Hydromorphone HCl, Glycerin, Lemon - Bioadhesive Slow Released Gel

  12. Need to try something unique? TALK TO US !!! Work with you to create a unique compound to meet your patients’ needs Member of Professional Compounding Centre of America (PCCA)

  13. Questions???

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