1. Palliative Care Malignant Wounds Compounding Pharmacy’s Approach
Dennis Wong, B.Sc. (Pharm.)
CD Whyte Ridge Pharmacy
123 G Scurfield Blvd., Winnipeg
(204)

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
Pt keep it SL for 10min, Pre-fill syringes, Filtered Needles, if pt cannot hold liq properly, then lollipops, lozenges

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 (

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

6. - 2 to 4 sprays to surrounding area or specific painful spots
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
Aq gel easy to wash off with Normal saline, polyox bandage is cellulose powder mixture that you can mix medications in it, abosrb fluid so good for oozing wounds, puff it to wound, spray with NS & puff again until you get a few layer, can be wash away with NS irrigation

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???