NICE asthma guidance

There are important differences between new NICE recommendations on asthma treatment and current “standard practice” in the UK. For example, NICE NG 80 recommends an early 4-8 week trial of montelukast plus low dose ICS if newly diagnosed asthma is not controlled by a low dose ICS inhaler alone. An ICS (low dose)/LABA combination is only recommended if that trial is unsuccessful – with a trial of maintenance and reliever therapy (MART) regimen recommended BEFORE considering any increase in ICS dose. Yet more change in the world of respiratory medicine.  

Generic prescribing of anti-seizure drugs

The MHRA has updated guidance on switching between different brands of anti-seizure drugs The revised guidance now clearly states that the potential for clinically relevant differences to exist between different manufacturers’ products in Category 3 is considered to be extremely low and that therapeutic equivalence between products can be assumed. Category 3 drugs include levetiracetam, gabapentin, pregabalin and ethosuximide. Importantly, the revised guidance also draws attention to the importance of considering patient/carer perceptions and the possible impact of patient factors such as learning disability or mental health problems whenever product changes are contemplated.  

NICE Reminder that antibiotics should not be used to treat the majority of sinus infections

NICE Guideline 79 strongly reminds us that antibiotics are very rarely needed for acute sinusitis – with a clear statement that antibiotics SHOULD NOT be offered at all in the first 10 days unless a person is systemically very unwell or at high risk of complications. A back-up prescription for antibiotics to be collected if symptoms worsen rapidly or do not improve by day 17 could be considered after day 10, but only when a bacterial cause is likely. The guideline is supported by a really useful concise visual summary. A related press release underlines the need to reinforce messages about appropriate […]

Medicine Matters Autumn 2017: Medicines information for care staff in a social setting

Medicine Matters Autumn 2017 The Autumn 2017 newsletter covers: CQC – The state of health care and adult services in England Lessons learnt: Transdermal Patches Annual Flu Vaccine

Lactose-Free Medicines

Have you seen an increase in requests for lactose and/or gluten-free medicines? Are you concerned that people may be being prescribed risky unlicensed specials because of misplaced anxiety about the possible effects of very small amounts of lactose or gluten in medicines? The Specialist Pharmacy Service is here to help. Their suite of resources on lactose in medicines and their guide to gluten in medicines should help: identify licensed lactose-free medicines, and put the issues into proportion very small amounts of lactose in medicines less lactose from typical daily medicines intake than found in one cup of milky tea such low level […]

Morphine Injections Supply Problems

Currently, there are national supply issues with Morphine Injections, predominately 10mg/ml amps but other strengths may be in short supply.

Practices should continue prescribing morphine injection first line in palliative care but contact community pharmacies at the point of writing the prescription to ascertain stock levels so the prescription can be written for the available strength of amp and correct dose. Do not use morphine if the 10mg, 15mg, 20mg and 30mg ampoules are not available.

Prescribe short duration prescriptions of morphine (no more than 5/7 days) in order to ensure we can maintain supplies to all patients in need.

Please ensure that all prescriptions and administration dosages are double checked by GP practices, Community Pharmacists and Community Nursing to reduce the risk of prescribing and administrative errors and that this is clearly communicated to patients and carers.

Miconazole (Daktarin) oral gel _ interaction with warfarin

The latest Drug Safety Update (Sept 2017) highlights that: despite repeated warnings, the MHRA continue to receive reports of harm or potential harm due to concomitant use of miconazole oral gel and warfarin. OTC miconazole oral gel is no longer licensed for sale to people taking warfarin. The MHRA have provided the following advice for healthcare professionals: bleeding events, some with fatal outcome, have been reported with use of miconazole oral gel by patients on warfarin patients taking warfarin should not use over-the-counter miconazole oral gel available from pharmacies if the concomitant use of miconazole oral gel with an oral anticoagulant […]

Health Matters: preventing ill health from alcohol and tobacco use – PHE Call to ACTION

Public Health England has issued a CALL TO ACTION to all healthcare professionals to help prevent ill health linked to alcohol & tobacco use The associated guidance sets out the scale of the problem and provides a range of resources to assist identification and the provision of brief advice (BA). ALL healthcare professionals are asked to: Make it your responsibility to always ask patients about their alcohol consumption and smoking, and to provide simple and short advice and support to help patients to stop smoking and to minimise harmful alcohol consumption. Access free online training to become confident in the […]