Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

Drug Safety Update - July 2018

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

This issue advises of the risk of airway obstruction from aspiration of loose objects when using pressurised metered dose inhalers (pMDI). There have been 22 reports in the UK of accidental inhalation of the mouthpiece cover or objects that have become trapped in the inhaler since 1987 with a further 36 cases reported outside of the UK. It is suggested that patients using pMDI inhalers are advised to:

  • store the inhaler with the mouthpiece cover correctly in place
  • remove the mouthpiece fully before using the inhaler
  • shake the inhaler to remove loose objects that may not be visible before use
  • check the inside and outside of the mouthpiece are clear before inhaling a dose
  • not use damaged inhalers

Yellow Cards should be submitted to report adverse incidents during use of inhalers and are also invited in this issue for suspected adverse reactions associated with medicines taken during pregnancy experienced by women or the baby or child.

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

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NICE Guidance - July 2018

The National Institute of Health and Care Excellence (NICE) have published new or updated guidance for the month of July 2018. This month there is one guideline that impacts upon primary care.

The Rheumatoid arthritis in adults guideline has been published, it updates and replaces existing guidance. It covers diagnosing and managing rheumatoid arthritis. It aims to improve quality of life by ensuring that people with rheumatoid arthritis have the right treatment to slow the progression of their condition and control their symptoms. People should also have rapid access to specialist care if their condition suddenly worsens.

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

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CKS Updates - June 2018

During June 2018 Clinical Knowledge Summaries were published or updated in the following areas.

New topics were published for:

The following topics were all reviewed:

The majority of topics have undergone reviews and minor restructures.

The most significant changes were to the Fungal skin infection - foot topic which has had complications and differential diagnosis nodes added. Management recommendations have been updated in line with the current literature and the Prescribing Information section has been updated and expanded.

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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