Have you read Soliman et al.'s 2025 systematic review and meta-analysis in the management of neuropathic pain? How might it change your practice? www.thelancet.com/action/showP...

Good morning from the gallery! Looking forward to going live at 9 after our intro VT 🎬

Our Resources Portal is now open to delegates on our 2025 course, who should now all have logins. We’ll be adding to it as the course gets underway, including enabling our practice question bank. Visit pallmed.pro/resources, or book your course place via pallmed.pro/book if you haven’t already!

Have you learned your controlled drug schedules? Knowing the relevant schedules and the legal restrictions placed upon common palliative care medicines can be helpful, along with how you may need to advise patients looking to take these medicines abroad. GOV.UK has more: www.gov.uk/guidance/con...

Opioids for chronic breathlessness ≠ “last resort”. Currow & Johnson (2020) remind us: low‑dose morphine can improve function & QoL when optimised, monitored, and individualised. Not about sedation — about living better, breathing easier.

Our revision flashcards are in the process of being updated for 2025-2026, with some great new content added. You'll be able to pre-order the 8th Edition from 15th September, for release on 1st October. Course delegates can claim a FREE update in October. pallmed.pro/flashcards

🧠 Under the MCA 2005 (England & Wales), we decide for an adult lacking capacity by asking what’s in their ‘best interests’. In Scotland’s Adults with Incapacity Act, that phrase never appears. The focus shifts to benefit and least restrictive option, with statutory principles front and centre.

💊💊ALFENTANIL💊💊 Alfentanil’s pKa ~6.5, much lower than fentanyl (~8.4) or morphine (~8.0) At physiologic pH (7.4), ~90% of alfentanil exists in the unionised, lipid-soluble form → crosses the blood–brain barrier very rapidly This explains why alfentanil has the fastest onset of action of any opioid

Did you know, that the half life of phenobarbitone is an average of 4 days?! The way we use it in palliative care needs to be proportionate, specialist-led, and congruent with known pharmacokinetics. @bmj.com Supportive and Palliative Care has more: spcare.bmj.com/content/earl... #palliativecare

Although an older study, this placebo-controlled double-blind RCT found no net benefit using SC ketamine in general cancer pain. 6 years later, Fallon et al. Looked more specifically at neuropathic cancer pain. pubmed.ncbi.nlm.nih.gov/22965960/

Grief, according to Kübler-Ross: Heard grief has “5 stages” you must follow? Denial → anger → bargaining → depression → acceptance was never a rigid sequence. Kübler-Ross saw it in those facing terminal illness. You might skip, loop, or feel several at once. It’s a guide, not a timetable.

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Naloxegol’s long tail prevents it from reaching the CNS where it would otherwise reverse the analgesic effects of opioids. It works peripherally in the gut.

Let’s talk Opioid-Induced Constipation (1/4) On opioids and can’t go? It’s not you, it’s your gut. Opioids slow bowel movement, dry out stool, and cut gut secretions. That’s a recipe for constipation – even with a great diet.

Which of the following statements about octreotide is most accurate? 1️⃣ Exerts action through somatostatin receptor blockade 2️⃣️ Increases insulin secretion 3️⃣ Commonly causes hyperthyroidism 4️⃣ Increases variceal bleeding risk 5️⃣ Is labelled with technetium in nuclear medicine imaging 📊 Show results

Our Palliative Medicine course is open to everyone, and it’s been great to see delegates booking from across the world. If the time zones don’t fit, remember you get access to our resources, handouts, questions and more. Drop us a line or check out pallmed.pro/book for more!

Delighted that @pharmacopalliation.bsky.social will be presenting again at this year’s course (pictured left) We’re looking forward to it!

BOOKING OPENS 9am GMT+1 for our 12th annual Palliative Medicine Exam Revision Course. Whether you’re a UK or international doctor sitting the Specialty Certificate Examination, or an established professional looking for CPD, check out our topic list below, or visit Pallmed.pro/book for more!

So many familiar faces! Jonathan’s at #PCC2025 today, so if you’ve seen our flashcards, been on one of our courses, authored in (/already read) Case Histories in Palliative Medicine, or just want to say ‘hi’, please do! oxford.ly/4hG4C9B

Good luck to all Palliative Medicine SCE candidates. You've done all you can do now. Step away from the PCF.

Delegates on our December 2024 course are now entitled to 30% discount on this title. A personal discount code can be activated via your resources portal for a limited time.

It’s finally here! @oxfordunipress.bsky.social Oxford Case Histories in Palliative Medicine “guides medical professionals and trainees through 52 cases curated to illustrate the varied and often complex landscape of palliative medicine.” oxford.ly/4hG4C9B

TRAMADONT: Ten reasons to avoid Tramadol.

Sitting the #Palliative Medicine SCE? Here’s a question for you on #Macmillan grants…

Who prescribes parenteral NSAIDs in cancer pain management? COX-2 selective agents show fewer GI side effects and have a lesser impact on platelet aggregation than their non-selective counterparts. Parecoxib, a pro-drug of valdecoxib, is a COX-2 selective NSAID licenced for parenteral use.

Dear followers, If you can help... LIKE and REPOST. Many thanks! #PalliativeCare #HAPM #HPM #HAPC #Hospice

It’s still surreal to see our textbook available for preorder! 📚 Thank you to everyone who contributed. Excited to share this work and knowledge. #newbook #academia #palliativecare

Fallon et al. found oral ketamine no better than placebo in cancer-related neuropathic pain, cementing a role more as an ‘anti-hyperalgesic’ in this context, although a niche highly-selected subset may benefit… pmc.ncbi.nlm.nih.gov/articles/PMC...

We were asked what “seminal papers” have influenced the practice of #palliativecare over the last couple of decades. There have been many, but here’s a couple for starters…

@christiplady.bsky.social thanks for coming along to present last week. The fact about oral iron replacement being more effective on alternate days (because TDS dosing increases hepcidin and decreases enteral absorption) came up on Friday’s ward round! Was able to significantly reduce tablet burden.

Thanks to everyone who made our last SCE revision course of 2024 a success. We enjoyed it, and hope our palliative care docs found it useful. Fantastic talks from @pharmacopalliation.bsky.social , Mark Teo, Chris Tiplady, Lisa Molus, & Anna Grundy. Our delegates have access on pallmed.pro/resources