Tablet Press
The prescribing newsletter for GPs, nurses and pharmacists
NHS Nene CCG and NHS Corby CCG
I
ssue 98
November 2014
•
Lipid modification after MI: effect of ezetimibe on risk of death
A UK observational study suggests that, compared with simvastatin monotherapy, use of statins at higher lipid-
lowering equivalent doses may be associated with a reduced risk of death after acute myocardial infarction. This is
consistent with clinical trial data and the NICE clinical guideline on lipid modification. However, despite a greater
reduction in cholesterol, use of ezetimibe plus a statin did not statistically significantly reduce the risk of death
compared with simvastatin monotherapy. The observational nature of the study and in particular the small size of the
ezetimibe group limits the conclusions that can be drawn. Nevertheless, there remains no published evidence that
ezetimibe, alone or added to a statin, reduces the risk of cardiovascular disease or mortality compared with an active
comparator.
Northamptonshire remains above the national average in its use of ezetimibe.
Medicines Evidence Commentary : Lipid modification after myocardial infarction: effect of ezetimibe on risk of death
•
Oral doses of amoxicillin and ampicillin for children
The recommended oral doses of amoxicillin and ampicillin for children were increased in the BNF in April 2014 to
address concerns that children may have been receiving inadequate doses. The HPA has updated its “Management
of infection guidance for primary care”
http://www.plain.pathfinder-rf.net/nene/therapeutics/guidelines-antimicrobial-
prescribing/ and the amoxicillin dose for otitis media recommended is now in-line with the BNF.
•
Urinary tract infection: diagnosis guide for primary care
This guidance has been updated by Public Health England and is part of the Primary Care Guidance; Diagnosing and
Managing Infections.
This guidance describes:
when to send urine for culture in women and men over 65 years old
when to send urine for culture in women and men with catheters
when to consider a UTI in children aged between 3 months and 3 years old
when to consider a UTI in children under 3 months old
https://www.gov.uk/government/publications/urinary-tract-infection-diagnosis
•
Boostrix for pregnant women
The pertussis containing vaccine for pregnant women changed from Repevax to Boostrix on 1 July 2014 and the PGD
was amended accordingly; please ensure you are using the right vaccine for the correct cohort. Repevax should now
be only used for pre-school boosters. Please send any comments t
o xxxxxxx.xxxxxx@xxx.xxx
•
Budesonide / formoterol combination inhalers need to be prescribed by brand
There are now 2 different inhaler devices containing budesonide and formoterol combinations; Symbicort and
DuoResp. The products are bioequivalent but the devices are different and the strengths are stated differently
(Symbicort as the “metered” dose of 400/12 or 200/6 and DuoResp as the “delivered” dose of 320/9 or 160/4.5).
DuoResp is included in the new Northamptonshire COPD guidelines.
The intended product should be prescribed by brand to ensure that the patient gets the correct inhaler.
•
NICE bites on Pathfinder
A new page has been created under the Therapeutics section of Pathfinder to save copies of the “NICE bites” which
are useful, concise summaries of NICE Clinical Guidelines produced by UKMI. Recent editions include Dyspepsia
and GORD, CKD, Lipid Modification and AF.
http://nww.pathfinder-rf.northants.nhs.uk/nene/therapeutics/nice-bites/
•
Blood glucose testing strips
If patients are purchasing their own BGT meters from pharmacies, they should be advised that only CareSens N strips
will be routinely prescribed on FP10 by their GP (unless an alternative meter has been advised by a specialist for a
specific reason). If patients chose to purchase an alternative meter then their practice is unlikely to be willing to
prescribe the corresponding BGT strips.
•
Reminder - email addresses for the Prescribing and Medicines Management Team
The email suffixes for the team, which were previously
xxxxxxxxx.xxxxxxx@xxxxxxxxx.xxx.xx are now
xxxxxxxxx.xxxxxxx@xxxxxxx.xxx.xx.
This edition is also available on PathfinderRF via the following link http://nww.pathfinder-rf.northants.nhs.uk/nene
and on the Nene CCG and Corby CCG websites
Disclaimer
Information in this newsletter is believed to be accurate and true. NHS Nene CCG and NHS Corby CCG and their employees accept no liability for
loss of any nature, to persons, organisations or institutions that may arise as a result of any errors or omissions.
01604 651359
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