Prescribing Advice for GPs

NICE Guidance – August 2010

August 26, 2010 at 9:07 am | In Prescribing Extra - Other |  Print | 1 Comment

The National Institute of Health and Clinical Excellence has published new guidance for the month of August 2010. This month there are three clinical guidelines that impact upon primary care.

The Chronic Heart Failure guideline (QRG) is an update to the 2003 guideline. It covers the care and treatment of people with chronic heart failure and includes updates on diagnosis, pharmacological treatment, monitoring and rehabilitation.

The Hypertension in Pregnancy guideline (QRG) covers the care and treatment of women who have or are at risk of developing hypertension in pregnancy. It contains pre-conceptual advice and advice on the diagnosis and management during pregnancy, birth and the postnatal period.

The Transient Loss of Consciousness in Adults guideline (QRG) covers the assessment, diagnosis and specialist referral of adults and young people (aged 16 and older) who have experienced transient loss of consciousness.

Action: Clinicians should be aware of these guidelines. They will be a useful resource for clinicians who see patients with heart failure, women of child-bearing age and in cases of transient loss of consciousness.

Additional CKS Update – August 2010

August 24, 2010 at 11:11 am | In Prescribing Extra - Other |  Print | No Comments

Clinical Knowledge Summaries (CKS) has been further updated in August 2010 for the following clinical areas:

• Analgesia – mild-to-moderate pain (new)
• Corticosteroids – inhaled (new)
• Corticosteroids – oral (new)
• Corticosteroids – topical (skin, nose and eyes) (new)

Action: Clinicians who see patients with any of these conditions may find the new and updated information useful when reviewing current clinical practice.

CKS Update – August 2010

August 12, 2010 at 3:20 pm | In Prescribing Extra - Other |  Print | No Comments

Clinical Knowledge Summaries (CKS) has been updated in August 2010 for the following clinical areas:

• Breathlessness (new)
• Bronchiectasis (new)
• Epistaxix (new)
• Hepatitis A (new)
• Hepatitis B (new)
• Hypercalcaemia (new)
• LUTS in men, age-related (prostatism)

Action: Clinicians who see patients with any of these conditions may find the new and updated information useful when reviewing current clinical practice.

SMC Update – August 2010

August 11, 2010 at 11:05 am | In Prescribing Extra - Other |  Print | No Comments

The Scottish Medicines Consortium (SMC) has issued its monthly advice on new medicines.

Betamethasone medicated plaster (Betesil^®) has been rejected for the treatment of inflammatory skin disorders which do not respond to treatment with less potent corticosteroids. The economic analysis was not sufficiently robust.

Aripiprazole (Abilify^®) has been accepted for restricted use for the treatment of schizophrenia in adolescents 15 years and older. A child/adolescent psychiatrist should initiate and supervise management.

Dutasteride / tamsulosin (Combodart^®) has been accepted for treatment of moderate to severe symptoms of benign prostatic hyperplasia (BPH) and to reduce the risk of retention or surgery in patients with moderate to severe symptoms of BPH in whom concomitant use of these medicines is appropriate.

Sitagliptin / metformin (Janumet^®) has been accepted for use in combination with a sulphonylurea (i.e. triple therapy) an adjunct to diet and exercise in patients with type 2 diabetes who are inadequately controlled on maximal tolerated doses of metformin and a sulphonylurea.

Indacaterol (Onbrez Breezhaler^®) has been accepted for maintenance bronchodilator treatment of airflow obstruction in adult patients with chronic obstructive pulmonary disease (COPD). The review notes that indacterol was superior in improving lung function (FEV₁) compared to other long-acting bronchodilators at 12 weeks follow up, however other agents are available at lower cost.

Action: Clinicians should be aware of the recommendations of the SMC. Routine use of rejected and restricted medicines should be avoided.

NICE Guidance – July 2010

July 28, 2010 at 9:44 am | In Prescribing Extra - Other |  Print | No Comments

The National Institute of Health and Clinical Excellence has published new guidance for the month of July 2010.

This month there is a clinical guideline and public health guidance that have an impact on primary care. The clinical guideline details the care of adults with, or at risk of, delirium in hospital and in long-term residential care or a nursing home. The public health guidance reviews dietary interventions and physical activity interventions for weight management before, during and after pregnancy.

Action: Clinicians should be aware of these guidelines. They will be a useful resource for clinicians who care for patients in residential care or women of child-bearing age.