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Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

NICE Guidance - March 2018

The National Institute of Health and Care Excellence (NICE) have published new or updated guidance for the month of March 2018. This month there are two guidelines that impact upon primary care.

The Attention deficit hyperactivity disorder guideline has been published and replaces previous guidance from 2008. It covers recognising, diagnosing and managing attention deficit hyperactivity disorder (ADHD) in children, young people and adults. It aims to improve recognition and diagnosis, as well as the quality of care and support for people with ADHD.

The Heavy menstrual bleeding guideline has been published and replaces previous guidance from 2007. It covers assessing and managing heavy menstrual bleeding (menorrhagia). It aims to help healthcare professionals investigate the cause of heavy periods that are affecting a woman’s quality of life and to offer the right treatments, taking into account the woman’s priorities and preferences.

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

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SMC Update - March 2018

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

Lacosamide (Vimpat®) has been rejected for use as monotherapy in the treatment of partial-onset seizures with or without secondary generalisation in adolescents and children from 4 years of age with epilepsy. The manufacturer failed to make a submission.

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

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Drug Safety Update - March 2018

The Medicines and Healthcare products Regulatory Agency (MHRA) has published Drug Safety Update for March 2018 (PDF).

This issue advises clinicians that head lice treatments carry a risk of serious burns if treated hair is exposed to open flames or other sources of ignition. Eight cases of serious burns associated with Hedrin® 4% cutaneous solution have been reported to the MHRA since the product was licensed in 2005. Parents, carers and the people with head lice should be advise that they should not smoke around treated hair and that it should be kept away from open flames or other sources of ignition, including in the morning after overnight application until hair is washed.

The issue also advises readers that GP practices that share information with the Clinical Practice Research Datalink can now access free quality improvement reports designed to improve patient safety and the quality of prescribing. The reports are also likely to be useful at annual appraisals.

This issue also contains a summary of recent drug and device alerts, including details of the ellaOne® pregnancy registry and details of the restrictions on the use of ulipristal acetate (Esmya®) following reports of liver injury.

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

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CKS Updates - February 2018

During February 2018 Clinical Knowledge Summaries were updated in the following areas.

The following topics were all reviewed:

The majority of topics have undergone reviews and minor restructures.

The most significant changes are to the Balanitis and Breast Screening topics where the background, diagnosis and management sections have been expanded or amended. The Bites - human and animal has seen the antibiotic choices simplified and doses have been added. The Obesity topic has been 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.

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