Greater Glasgow and Clyde Medicines

Key points:

Increased risk of fracture, hypomagnesaemia and subacute cutaneous lupus erythematosus (SCLE) are significant adverse effects associated with PPI use that have been reported by the MHRA.

MHRA Drug Safety Update January 2023

Key Messages:

• Polypharmacy guidance can be used by all healthcare professionals to improve patient care
• Pay particular attention to high risk medicines such as anticholinergics, antipsychotics and benzodiazepines as well as any medicine linked to falls
• Frailty can cause loss of function (including falls and confusion) and can be improved by early identification and polypharmacy medication review

• DOACs are high risk medicines commonly associated with prescribing errors
• Prescribing errors can lead to significant adverse events such as major bleeding or increased thrombotic risk due to suboptimal treatment
• When prescribing a DOAC, the following patient/clinical parameters must be considered: indication, age, actual body weight, renal/hepatic function, past medical history and concomitant medicines

The NHSGGC Venous Thrombosis in Malignant Disease guideline has been updated

Key Medicine Shortages – January 2023

• The NHS GGC Adult Blood Glucose and Combined Ketone Meter and Test Strip Formulary has been updated

• The Preferred List Formulary blood glucose meters for adult patients with type 1 and type 2 diabetes not on an insulin pump are now: Contour Plus Blue and Glucofix Tech

Guideline News December 2022

• Clostridioides difficile infection (CDI) has been associated with PPI use.
• The NHSGGC guideline on Management of Suspected or Proven Clostridioides difficile Infection (CDI) in Adults advises stopping gastric acid suppression (e.g. PPIs) where possible.

• In recent years there have been reports of a link between PPI use and pneumonia, however, evidence is conflicting and therefore there are no NHSGGC guidelines for the management of PPIs in patients with pneumonia.