In August 2020, in response to four deaths and more than 300 reported incidents with steroid replacement therapy involving patients with adrenal insufficiency, a National Patient Safety Alert was published by NHS England and NHS Improvement announcing the introduction of a new patient-held steroid EMERGENCY card. All patients with primary adrenal insufficiency are steroid dependent…
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We have had some interesting queries over the past few months which have required some time to answer in full. We also had some feedback from previous queries which we respond to below. All our visiting pharmacists are there to respond to your queries and if they can’t answer the question on the spot, we…
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The two opioids available for delivery via a transdermal patch in the UK are fentanyl and buprenorphine. Fentanyl products are licensed for severe and chronic pain that requires long-term opioids or that does not respond to non-opioids. Buprenorphine is available in two sets of products – the stronger patches have a similar license to fentanyl while the lower strengths are indicated for non-malignant pain when an opioid is necessary (they are used for cancer pain in some cases, where patients only require low opioid doses)…
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The MHRA has decided that stimulant laxatives can be inappropriately used by people wanting to lose weight – especially those who may have an eating disorder. In future, products such as Senna and Bisacodyl will sold in small pack sizes only and to people over 18…
Guy’s and St Thomas’ manufacturing unit has now ceased supply of 2% lidocaine in Lutrol gel and it is now distributed by Oxford Health – the NHS specials and wholesale supplier…
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The annual influenza vaccination programme has become an important strategy for protecting public health by providing vulnerable people with immunisation against the virus strains likely to be the most prevalent over the coming year. The best time to have the vaccination is each autumn, from the beginning of October, as this will provide protection throughout winter – the riskiest time…
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A letter in the recent BMJ Supportive and Palliative care journal(1) has raised questions on the safety of prescribing for 24-hour syringe pumps ahead of need. It reflects that the Gosport War Memorial inquiry has increased public and clinical awareness of the use of syringe pumps for the delivery of opioids…
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This NICE guideline was updated in July 2019 and covers the planning and management of end of life and palliative care for infants, children and young people (aged 0–17 years) with life-limiting conditions. It aims to improve the support available and involve young people and their families in decisions…
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1. What do we do if we find a fentanyl patch has fallen off? If you have a patch-checking chart, see when it was last observed in place. If it was still on the patient’s skin up to 12 hours ago, apply a new patch as the levels will not have fallen too far. Monitor…
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Fluconazole is a triazole antifungal agent which came into use in the late 1980s. It has a different chemical structure to its predecessor, ketoconazole, and is safer systemically. It is licensed for the treatment of topical fungal infections in the mouth, skin and genitals and for invasive, systemic fungal infections…
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The SPC for tapentadol has been revised to include the additional warning that concomitant use of other sedating medicinal products may result in sedation, respiratory depression, coma and death. Prescribers are advised to consider reducing the dose of one or both agents, if tapentadol is required in addition to one…
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