Greater Glasgow and Clyde Medicines

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

Key messages

• Preferred list salbutamol inhaler is now an Easyhaler® salbutamol 100 micrograms/puff dry powder inhaler
• Reducing the number of salbutamol metered dose inhalers (MDIs) dispensed would greatly reduce the carbon impact of inhalers in NHSGGC
• The main aims to reduce the environmental impact of inhalers are:
  • To use lower carbon footprint inhalers if appropriate for the patient
  • To improve disease control
  • To promote safe disposal of inhalers through community pharmacies

Key Points:

• Women with an intact uterus prescribed hormone replacement therapy (HRT), require both oestrogen and progestogen. The progestogen provides endometrial protection against the risk of endometrial hyperplasia and endometrial cancer.
• It is the responsibility of the prescriber to ensure robust systems are in place to prevent women with an intact uterus receiving unopposed oestrogen.

Key Medicine Shortages December 2023 here

Includes:

Co-trimoxazole 40mg/200mg/5ml oral suspension sugar free, Dicycloverine 10mg/5ml oral solution, Fluticasone 400microgram/unit dose nasal drops and Rifampicin 150mg capsules

General key messages

• Opioid patches are only suitable for stable pain and in certain circumstances (see below)
• Fentanyl patches are not suitable for opioid naïve patients due to their potency
• As transdermal opioid preparations are not interchangeable, patients should remain on the same preparation, prescribed by brand name
• Where specified brand is not available, to avoid missed doses, an alternative brand can be considered. Monitor closely for loss of pain control/opioid toxicity

Key Points

• Vitamin D levels should NOT be measured routinely.
• Vitamin D loading doses may differ depending on indication.
• Check NHSGGC Formulary for vitamin D preparation of choice prior to prescribing.

Thiamine supplementation is required in patients at risk of re-feeding syndrome regardless of route of nutrition (IV, oral, enteral feeding tube) and should be started immediately before nutrition is re-introduced where possible

Key messages:

• MyPsych has moved to NHS Scotland Right Decisions platform
• Effective from 1st November 2023
• Users are required to download new app to continue to access content

Key Messages:

• Liquid medications incur additional costs compared to other solid dosage formulations and for the majority of adult patients with swallowing difficulties, liquid formulations are not required
• Excipients in liquid medications such as sorbitol often cause GI side-effects and the effects can be cumulative in patients prescribed multiple liquids
• If a liquid medication is prescribed and/or supplied due to an issue sourcing solid dosage formulations, this should be reviewed as soon as the solid dosage formulation is available