Greater Glasgow and Clyde Medicines

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• Most medicines are unlicensed for administering via an enteral feeding tube (EFT). Therefore, consider if it is essential and if there is an alternative.
• Check the type of EFT including its size as this will influence drug efficacy and potential tube blockage.
• Consider the advantages and disadvantages of drug formulations available for potential EFT administration (see tables in blog).
• Check for potential interactions (drug-drug, drug-tube and drug-feed) as these can cause tube blockages and reduce drug efficacy.
• Proton Pump Inhibitors (PPIs): omeprazole enteric-coated (dispersible) tablets (e.g. Losec MUPS®) are well known for causing tube blockages and are unlicensed for tube administration. The NHSGGC-preferred option which is licensed for this route is lansoprazole orodispersible tablets.
• Consider seeking input from a pharmacist and/or a dietitian.

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• Patients admitted to hospital who take warfarin (or any other coumarin anticoagulant), should be considered for a switch to a suitable direct oral anticoagulant (DOAC). This recommendation is based on the reduced bleeding risk with DOACs when compared with warfarin and improved patient acceptability given the lack of need for ongoing monitoring in hospital and community-based clinics.
• The Appropriate and Safe Conversion from Warfarin to a DOAC guideline available in the GGC Adult Therapeutics Handbook includes full detail, such as situations when patients should not be switched, recommended choice of DOAC and how to switch patients.

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• A new regional West of Scotland formulary is being developed, which will replace the NHSGGC formulary over time.
• The latest edition of the regular Formulary Focus newsletter has been issued to help keep staff in participating Health Boards up-to-date with project progress.
• Excellent progress has been made so far, with the review of four chapters currently underway (Cardiovascular, Gastro-Intestinal, Respiratory and Skin).
• Nominations are being sought from NHSGGC staff who are interested in membership of the new West of Scotland Formulary Committee.

This post summarises the latest NHS Greater Glasgow and Clyde decisions relating to new medicines assessed by SMC and considered by the Area Drug and Therapeutics Committee (ADTC) and uses a nationally developed format specifically aimed for patients and the public.

For full details of the medicines included in this post that are available for use, including any restrictions on prescribing, please see the relevant entry in the GGC Formulary.

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