Greater Glasgow and Clyde Medicines

Key Messages
NHSGGC adult guidelines for linezolid have been updated and now include:

• An outpatient and discharge supply checklist to be completed by the prescriber
• Instructions of when and how to refer a patient to the NHSGGC Outpatient Antimicrobial Therapy (OPAT) service for follow-up monitoring

Management of Type 2 Diabetes – What’s New?

Summary

• Sodium-glucose co-transporter 2 (SGLT2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists benefits in cardiovascular and renal outcomes
• Canagliflozin and Diabetic Kidney disease (DKD) licence extension
• Semaglutide, the first oral GLP-1 receptor agonist

The updated guidance includes:

• The 4 main principles drawn from Caring for people in the last days and hours of life – NHS Scotland 2014
• Key actions when someone is dying and at the time of and after death
• Clear guidance on Anticipatory/Just In Case medication and advice on when to seek support and advice
• Electronic links throughout that can be accessed to provide additional information

From February 2021, the maintenance dose of apremilast (one 30mg tablet twice daily) will be prescribed by the patient’s GP (one pack of 56 tablets per prescription). Specialist dermatology and rheumatology services will continue to prescribe the initial titration pack for new patients, and as before this will be dispensed in community pharmacies.

Hospital Electronic Prescribing and Medicines Administration (HEPMA) is a new digital system that will replace the paper drug chart (Kardex) for inpatient areas across NHSGGC.

Key messages

• Pico 7® Single Use Negative Pressure Wound Therapy (sNPWT) dressing kit will be initiated on wound closure in theatre and will remain in situ for one week, under the ongoing care of acute midwives
• When used for this indication, Pico 7® sNPWT kit or additional Pico 7® dressings should not be prescribed in Primary Care
• Women will be provided with details of acute midwife and who to contact if a new dressing is required or for further advice on device

Guideline News January 2021

The COPD digital support service (https://support.nhscopd.scot) is available to all NHS GG&C patients with COPD who have access to the internet.

The NHSGGC Delirium Diagnosis, Risk Reduction and Management in Acute Services guideline (StaffNet link) recommends undertaking a medication review. This blog provides advice on how to undertake a medication review using the TIME structure.

Following a successful pilot period, the new SNAP (Scottish & Newcastle Acetylcysteine Protocol) guideline is being introduced across GGC, adult services, on 8th Feb 2021.