Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

NICE Guidance - August 2016

The National Institute of Health and Care Excellence (NICE) have published new or updated guidance for the month of August 2016. This month there are four clinical guidelines that impact upon primary care.

The Heavy menstrual bleeding clinical guideline was updated to include new recommendations for drug treatments for women with large fibroids based on new evidence.

The Autism spectrum disorder in adults clinical guideline was reviewed and while no new recommendations were made, two research recommendations were removed.

The Fertility problems clinical guideline has been reviewed in particular on intrauterine insemination however the new evidence did not justify a change to the recommendation.

The Palliative care for adults: strong opioids for pain relief clinical guideline was reviewed and updated to include links to the Controlled drugs: safe use and management guideline. Two out of date research recommendations were also deleted.

Action: Clinicians should be aware of this month's new guidance and implement any necessary changes to practice.

Share 'NICE Guidance - August 2016' on Email Share 'NICE Guidance - August 2016' on Delicious Share 'NICE Guidance - August 2016' on Digg Share 'NICE Guidance - August 2016' on Facebook Share 'NICE Guidance - August 2016' on Google+ Share 'NICE Guidance - August 2016' on reddit Share 'NICE Guidance - August 2016' on StumbleUpon Share 'NICE Guidance - August 2016' on Twitter

SMC Update - August 2016

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

Alirocumab (Praluent®) has been accepted for restricted use in adults with primary hypercholesterolaemia (heterozygous familial and non-familial) or mixed dyslipidaemia, as an adjunct to diet and other medication, if tolerated. The restriction limits use specialist lipid clinics in patients at high cardiovascular risk. This advice is also contingent upon the continuing availability of the PAS in NHS Scotland or a list price that is equivalent or lower.

Insulin degludec (Tresiba®) has been accepted for use in the treatment of diabetes mellitus in adults.

Levofloxacin (Quinsair®) has been accepted for restricted use in the management of chronic pulmonary infections due to Pseudomonas aeruginosa in adult patients with cystic fibrosis. The restriction limits use to third line after colistimethate sodium (first line) and tobramycin (second line).

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

Share 'SMC Update - August 2016' on Email Share 'SMC Update - August 2016' on Delicious Share 'SMC Update - August 2016' on Digg Share 'SMC Update - August 2016' on Facebook Share 'SMC Update - August 2016' on Google+ Share 'SMC Update - August 2016' on reddit Share 'SMC Update - August 2016' on StumbleUpon Share 'SMC Update - August 2016' on Twitter

Drug Safety Update - August 2016

The Medicines and Healthcare products Regulatory Agency (MHRA) has published Drug Safety Update for August 2016 (PDF).

Following early termination of a clinical trial it is recommended that riociguat (Adempas®) should not be used to treat patients with pulmonary hypertension associated with idiopathic interstitial pneumonias. This medication should be under specialist supervision.

There is also a summary of letters sent to healthcare professionals in July including a letter advised that posaconazole (Noxafil®) tablets and suspension are not interchangeable and that inadvertent changes between the two formulations has led to under-dosing or over-dosing.

Action: Clinicians should be aware of this month's new guidance and implement any necessary changes to practice.

Share 'Drug Safety Update - August 2016' on Email Share 'Drug Safety Update - August 2016' on Delicious Share 'Drug Safety Update - August 2016' on Digg Share 'Drug Safety Update - August 2016' on Facebook Share 'Drug Safety Update - August 2016' on Google+ Share 'Drug Safety Update - August 2016' on reddit Share 'Drug Safety Update - August 2016' on StumbleUpon Share 'Drug Safety Update - August 2016' on Twitter

CKS Updates - July 2016

During July 2016 Clinical Knowledge Summaries were updated for the following topics:

There were no major changes other than to the Head injury topic that was updated in line with NICE guidance.

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

Share 'CKS Updates - July 2016' on Email Share 'CKS Updates - July 2016' on Delicious Share 'CKS Updates - July 2016' on Digg Share 'CKS Updates - July 2016' on Facebook Share 'CKS Updates - July 2016' on Google+ Share 'CKS Updates - July 2016' on reddit Share 'CKS Updates - July 2016' on StumbleUpon Share 'CKS Updates - July 2016' on Twitter

Vitamin D advice issued

Public Health England has issued new advice on vitamin D based on the recommendations of the Scientific Advisory Committee on Nutrition.

The advice notes that vitamin D is made in the skin on exposure to UVB in sunlight but since this is difficult to quantify a daily dietary intake of 10 micrograms is being recommended.

It is noted that in spring and summer the majority of the population get enough vitamin D through sunlight on the skin and a healthy, balanced diet. In autumn and winter months it is difficult for people to meet the 10 microgram recommendation from consuming foods naturally containing or fortified with vitamin D so people should consider taking a daily supplement containing 10 micrograms of vitamin D.

The advice also considers people whose skin has little or no exposure to the sun, like those in institutions such as care homes, or who always cover their skin when outside and recommends that they need to take a supplement throughout the year.

Ethnic minority groups with dark skin, from African, Afro-Caribbean and South Asian backgrounds, may not get enough vitamin D from sunlight in the summer and therefore should consider taking a supplement all year round.

Recommendations are also made for children under 5. Children from birth to 1 year old who are breast feed should be given a daily supplement containing 8.5 to 10 micrograms of vitamin D. Formula fed children of this age consuming 500ml or more each day do not require a daily supplement because infant formula is fortified with vitamin D. Children aged 1 to 4 years should be given a daily supplement containing 10 micrograms of vitamin D. It is noted that low-income families can access vitamin D free of charge via Healthy Start schemes.

Action: Clinicians should be aware of this new advice. The advice consistently refers to "dietary sources" of vitamin D including foods naturally containing or fortified with vitamin D and supplements. As such prescribing of vitamin D purely for supplementation following this advice should be resisted.

Share 'Vitamin D advice issued' on Email Share 'Vitamin D advice issued' on Delicious Share 'Vitamin D advice issued' on Digg Share 'Vitamin D advice issued' on Facebook Share 'Vitamin D advice issued' on Google+ Share 'Vitamin D advice issued' on reddit Share 'Vitamin D advice issued' on StumbleUpon Share 'Vitamin D advice issued' on Twitter

« Older Posts

Prescribing Advice for GPs is powered by WordPress.
Subscribe for Free to our RSS or Atom Feeds for New Entries.
Akismet has protected Prescribing Advice for GPs from 788,102 spam comments.

atomic-wealth
fond-illness
summer